Prematurity is one of the most stubborn health problems in our society, no other problem impairs afflicted children more seriously and long lasting. In spite of remarkable progress in the treatment of premature infants, the outcomes are still not satisfying and the prematurity rate is still increasing. Prevention of prematurity therefore seems a public health goal with a high priority in obstetrics. Health promotion should be an important issue of counseling in the gynecological practice, recommending favorable living habits in and before pregnancy. Risk factors have to be identified and adverse influences removed for the primary prevention of premature delivery. Secondary prevention requires screening with predictors for the treatment or avoidance of an imminent premature delivery, while the goal of tertiary prevention is the avoidance of health consequences for mother and newborn from a premature delivery and the prevention of recurrence. Not all risk factors for prematurity are known, so far. The identification and removal of unfavorable factors in the society and the individual are important tasks for the future. Better predictors for screening have to be identified and evaluated for the prevention of a premature delivery in order to make tertiary prevention a rare necessity. The prevention of prematurity remains a persistent challenge to obstetrics.

Child↗

PubMedDate not supplied

[Need for standardized pain therapy in pediatric oncology patients].

Pain-management in pediatric-oncological patients is an interdisciplinary task. The working group pain--therapy of GPO tries to work up an analgesic concept for this group of patients. Pre-existing experience in the therapy with sustained release Morphine and Metamizol should be considered. The documentation-system is just worked up, we ask all pediatric oncological groups to cooperate.

Analgesics↗

PubMedDate not supplied

[Suture granuloma with calcium pyrophosphate deposits].

In the report two foreign body granulomas, one observed in the fibrous periarticular tissue and the other one in tendo achilles with depositions of crystals inside the granulomas are described. Polarisation microscopy exhibited birefringent crystals which stained black with the van Kossa reaction. The scanning electron microscopic appearance was that of calcium-pyrophosphate-dihydrate when compared with crystals of menisceal tissue in "chondrocalcinosis". The structure of the crystals was different from those that can be observed in calcifying tendinitis or in calcified scars. By X-ray microanalysis nearly identical peaks for calcium and phosphorus were measured, indicating the atomic composition of calcium-pyrophosphate-dihydrate. For the crystalline deposits were restricted to an acellular tissue between the foreign body material it is concluded that necroses in the fibrous periarticular tissues or tendons may be prone for deposition of calcium-pyrophosphate.

Achilles Tendon↗

PubMedDate not supplied

[Tuberculosis of the shoulder joint].

In contrast to specific shoulder girdle processes tuberculoses of the shoulder joint are observed relatively frequently. From 1955 up to and including 1980, 50 patients with omarthritis tuberculosa were surgically treated at the authors' clinic. Thirty were male, 20 female, 42 were Germans, 8 immigrant workers. Arthrodeses were performed in 28 cases, removal of bone or soft-tissue foci, or a combination of these, in 22. The left joint was affected in 26 cases (52%) and the right in 24 (48%). The youngest patient was 9, the oldest 78 years of age (average age 42.6 years). The time from the onset of complaints to diagnosis was about 1.6 years. Twenty-eight patients (56%) had previously had treatment for tuberculosis and 9 (18%) also had active tuberculosis localized elsewhere. Even though there were clear radiological changes in all cases, abscesses and fistulae or a combination of these in 27 cases (54%), the 1-hour ESR was normal or only slightly elevated (under 20 mm acc. to W.) in 29 patients (58%). The recurrences which occurred immediately after surgery or in the subsequent course of the disease healed without sequelae after secondary interventions. While they prolonged hospitalization they did not influence the result of surgery. Of the 38 (76%) patients who were followed up on average 3 years after the end of inpatient treatment, 30 (79%) had returned to work on average 1.1 year after being discharged from the hospital. Three had meanwhile been retrained for lighter work. In the discussion the etiology and pathogenesis, incidence, side localization, age and sex distribution, complaints, clinical and radiological findings, diagnosis, therapy, prognosis, and differential diagnosis of shoulder joint tuberculosis are reported on with reference to the relevant literature.

Abscess↗

PubMedDate not supplied

[Tuberculosis of the pelvic girdle].

Between 1955 and 1980 a total of 67 patients (42 female, 25 male) with advanced tuberculosis of the pelvic girdle underwent surgery at the authors' clinic. In 43 patients the sacroiliac joint was affected (in 2 cases bilaterally), in 11 the ischium, in 9 the pubic bone, and in 2 each the ilium and the sacrum. The average of the patients (who included 4 migrant workers) was 44. The youngest patient was 8, the oldest 67 years old. The average interval between the onset of complaints and diagnosis was 4.6 years (minimum 1 month, maximum 20 years). Thirty-eight of the patients had already had treatment for an organic or osteoarticular tuberculosis. Although 24 (35.8%) of the patients were simultaneously suffering from a florid, specific infection localized elsewhere, and abscesses, fistulas, or a combination of these were identified in 40 patients (59.7%), only 17 (25.4%) were in slightly impaired general condition, and in over one-half of the patients, the hourly blood sedimentation rate was normal or only slightly elevated (up to 20 mm n.W.). In 9 cases (13.4%) the only pointers to tuberculosis were the patient's history, clinical and radiological findings, and the subsequent evolution of the disease. In these cases the diagnosis could not be confirmed either by histologic or by bacteriologic study of focal tissue. In 67 patients, 66 osseous foci were removed and in 2 cases merely an abscess (after an average of 2-3 weeks' tuberculostatic therapy), the bone cavities were filled with a mixture of heterogeneous or autogenous spongiosa and tuberculostatics or merely with chemotherapeutic drugs, and primary closure of the wound was performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗

PubMedDate not supplied

[Tuberculosis of the iliosacral joints. Treatment, results, prognosis and differential diagnosis].

In comparison with other specific processes of the pelvic girdle tuberculous foci in the sacro-iliac joints are observed relatively frequently. In the last 26 years (1955 to 1980) 43 patients (28 female, 15 male; 39 Germans, 4 immigrant workers) with 45 sacroiliac tuberculosis were treated in the authors' clinic (44 by surgery). The youngest patient was aged 8, the oldest 67 (average age 33.9 years). Until the diagnosis was clarified the majority of the patients (39 = 92%) had been treated for sciatica and lumbago. In 24 (56%) of the patients the right sacro-iliac joint was affected, in 17 (39%) the left and in 2 (5%) both. Although all the cases showed advanced disease (with extensive destruction), and abscesses, fistulae or other tuberculous foci were found in the majority of the patients, the 1-hour blood sedimentation rates were normal or only slightly elevated in over 50% of them. In 35 cases (78%) the joint was completely destroyed. The post-operative complications (2 patients with 1 fistula each, 1 patient with a wound-healing impairment) did not have an adverse effect on the result of surgery. In the 37 patients (86%) who were examined on average 4.5 years after discharge from the hospital, no recurrences were found. Seventy-four percent of the sacro-iliac joints were partially or completely ankylosed; advanced postarthritic arthrosis was found in the remainder. Only one of the patients followed up, a mason, had to be retrained; the others had resumed their previous occupations on average 1.4 years after being discharged.

Adolescent↗

PubMedDate not supplied

Tubular epithelial cells as accessory cells for superantigen-induced T cell activation.

In various inflammatory kidney diseases, tubular epithelial cells (TEC) express major histocompatibility complex class II antigens. To assess whether they might have the capacity to directly activate T cells, human TEC in culture were treated with gamma interferon to induce class II expression. TEC were then cocultivated with staphylococcus enterotoxin and cloned T cells or highly purified peripheral T cells. After 1-2 days, release of interleukin 2 and of gamma interferon was seen; after 3-5 days T cell proliferation occurred. The proliferation could be inhibited by antibodies to class II antigens or by antibodies to ICAM-1; the latter is also expressed on TEC in inflammatory processes and on TEC in culture as well. In conclusion, human TEC might function as accessory cells for T cell activation and might support T cell dependent immune response.

Antibodies↗

PubMedDate not supplied

The delayed effects of ethacrynic acid on the stria vascularis of the guinea pig.

Guinea pigs were administered 40 mg ethacrynic acid per kg b.wt. and sacrificed at 30-48 minutes, 3-4 hours, 2 or 7 days post-drug. Cochlear potentials (EP and CP) were monitored before sacrifice. At 30-48 minutes, the potentials had decreased considerably, and a marked edema plus cytological changes were visible in the stria vascularis. The potentials had recovered to about 75% of their original value at 3-4 hours; some cell recovery was visible, but the edema was still present. Potentials recorded from the basal turn were normal at 2 and 7 days, although some strial cells showed deterioration.

Action Potentials↗

PubMedDate not supplied

Rural Hospital Center: eight years of service to rural hospitals.

Explore the source record for details and available documents.

California↗

PubMedDate not supplied

[Cytophotometric DNA measurements in mononuclear round cells of synovial fluid].

Cytophotometric investigations were performed on synovial fluid mononuclear round cells in patients with various joint diseases. In nearly all instances only round cells with a diploid DNA-content were found. No increased proliferation could be observed neither in patients with rheumatoid arthritis nor in patients with a high relative number of neutrophilic granulocytes in the synovial fluid.

Arthritis, Rheumatoid↗

PubMedDate not supplied

Comparison of cellular phenotypes in tumor cyst and ascitic fluid from ovarian serous carcinoma.

Density gradient centrifugation was applied to isolate cell subsets from tumor cyst and ascitic fluid in eight patients with ovarian serous carcinoma. A comparison of cellular composition and immunologic reactivity of cells from the cysts and from ascitic fluid in each patient was performed. Some differences in density profiles were found, but in each case the consistency of morphologic cell forms in the primary tumor and ascites was documented. Immunophenotypic analyses of isolated cellular fractions using polyclonal and monoclonal antibodies against ovarian carcinoma-associated antigens showed significant immunologic intratumoral heterogeneity. However, there was a similarity of antigen expression in cells from the primary tumors and ascitic fluids. Our study indicated that morphologic and antigenic characterization of a given tumor could be determined in a single representative sample of ascitic fluid.

Ascitic Fluid↗