Sequence analysis of ribosomal and mitochondrial genes of the giant liver fluke Fascioloides magna (Trematoda: Fasciolidae): intraspecific variation and differentiation from Fasciola hepatica

Complete sequences of ribosomal and mitochondrial genes of the giant liver fluke Fascioloides magna are presented. In particular, small subunit (18S) and internal transcribed spacers (ITS1 and ITS2) of the ribosomal gene (rDNA), as well as cytochrome c oxidase subunit I (cox1) and nicotinamide dehydrogenase subunit I (nad1) of the mitochondrial DNA (mtDNA), were analyzed. The 18S and ITS sequences were compared with previously published sequences of the liver fluke Fasciola hepatica. Fixed interspecific genetic differences were determined that allow molecular differentiation of F. magna and F. hepatica using either the PCR-RFLP method or PCR amplification of species-specific DNA regions. Additionally, intraspecific sequence polymorphism of the complete cox1 and nad1 mitochondrial genes in geographically distinct F. magna populations was determined. Based on the sequence divergences, short (< 500 bp) variable regions suitable for broader biogeographical studies of giant liver fluke were designed.     

Recombinant factor VIIa in massive haemoptysis associated with chronic necrotising aspergillosis

The successful use of recombinant activated factor VII (rFVIIa), in treating massive, life-threatening haemoptysis in a 55-year-old male patient with chronic necrotising aspergillosis, is reported. Patient diagnosed with chronic necrotising aspergillosis three months ago was admitted to our department with massive haemoptysis. Patient was treated as outpatient with itraconazole. One day post-admission, two doses of rFVIIa (30 microg x kg(-1)) were administered and the haemoptysis was successfully resolved. Two further doses of rFVIIa (30 microg x kg(-1) were given the following day, and after that there were no more recurrences of pulmonary haemorrhage. No thromboembolic or other adverse events were observed following rFVIIa therapy. Our findings suggest that use of rFVIIa may represent a safe and effective treatment choice for patients with haemoptysis due to aspergillosis.     

Zooplankton (Cladocera, Ostracoda), Chironomidae and other benthic faunal remains in sediment cores from nine North African wetland lakes: the CASSARINA Project

Palaeolimnological studies were carried out on sediment cores from nine North African wetland lakes. The lakes represented a variety of habitats ranging from freshwater to mixohaline conditions and with and without direct connections to the sea. Sediment cores were examined for records of recent environmental change during the 20th century period. Faunal remains analysed in the sediments included those of Cladocera, Ostracoda, Chironomidae, Mollusca and, at the sites with marine connections, Foraminifera. Cyprideis torosa littoralis was the most common ostracod, occurring in sediments from the seven sites linked with the sea and also in brackish water Sidi Bou Rhaba. In acid Megene Chitane ostracods were scarce, being represented by a single species (Cypria ophtalmica). Candona neglecta completely disappeared at two sites (Sidi Bou Rhaba and Bokka) during the 20th century. Of the Cladocera, Chydorus sphaericus was common in the moderately mixohaline sites and but Heterocypris salina occurred only where marine salinities were occasionally achieved (in Zerga, Ichkeul and Korba). Microinvertebrate assemblages in the Nile Delta lake cores and to a less extent in Zerga showed a clear response indicative of more fresher conditions occurring during the latter part of the 20th century. However the freshening trend began prior to construction of the Aswan High Dam (mid 1960s).With the exception of the most saline site (Korba), microinvertebrate communiuties at all the CASSARINA sites have experienced major disturbances during the 20th century. Changes in freshwater availability associated with increased human usage of water resources is perceived as a major factor regulating the abundance and occurrence of aquatic microinvertebrate species at these sites     

Right atrial pacemaker lead thrombosis incidentally detected by transesophageal echocardiography

In a 62-year-old man with permanent atrial fibrillation and recurrent stroke, a large right atrial thrombus attached to a permanent pacemaker lead was incidentally identified by transesophageal echocardiography. Surgical treatment, recommended because of the large dimensions of the mass, was refused by the patient, and thrombus was successfully dissolved by anticoagulant treatment. Pathogenesis of pacemaker lead thrombosis, clinical implications, diagnostic and therapeutic options are discussed.     

Fulminant meningococcal sepsis in a young child--a case report

We are presenting a case of isolated fulminant meningococcal sepsis with two and a half year old child. Initial symptoms were obscure and common to many medical conditions, but also previously described as symptoms of meningococcal sepsis. Unrecognizing the seriousness of the condition child died at home, within few hours after examination and discharge from the hospital. Autopsy and microbiological findings unquestionably proved that the child died from septic shock caused by fulminant meningococcal sepsis.     

Analysis of the compressive strain below the removable and fixed prosthesis in the posterior mandible using a digital image correlation method

It was the purpose of this study to determine and analyse strains in the bone of posterior mandible below the removable and fixed partial dentures using Digital Image Correlation Method. Dried mandible with shortened dental arch (Kennedy Class 1) was used in the experiment. The mandible model was prepared for accepting two types of restorations for bilaterally missing molars conventional therapy, and removable and fixed partial dentures were manufactured following standard prosthetic protocol. The models with prosthetic restorations placed in situ were subjected to loading of 50-300 N, and photographed using two digital cameras as part of the digital image correlation method equipment. Afterwards, the obtained data for strains within restored mandible during loading ciclus were analysed in the software Aramis and graphically presented. Percentage size of the mandible strains within the line section are from 0.14 to 0.19% for the removable partial denture experimental model and 0-0.14% for the fixed partial denture experimental model. The study has demonstrated that Digital Image Correlation method can be used to measure strain on the mandible surface and replacements during loading and that from biomechanical perspective both therapeutic modalities can be equally useful for the restoration of the mandible with bilaterally distal edentulous spaces.     

Vergleichende Uebersicht

Ohne Zusammenfassung     

Vergleichende Uebersicht der Vegetationsverhältnisse der Grafschaften Görz und Gradisca

Ohne Zusammenfassung     

The role of intrinsic muscle flaps of the foot for bone coverage in foot and ankle defects in diabetic and nondiabetic patients

Local muscle flaps, pioneered by Ger in the late 1960s, were extensively used for foot and ankle reconstruction until the late 1970s when, with the evolution of microsurgery, microsurgical free flaps became the reconstructive method of choice. To assess whether the current underuse of local muscle flaps in foot and ankle surgery is justified, the authors identified from the Georgetown Limb Salvage Registry all patients who underwent foot and ankle reconstruction with local muscle flaps and microsurgical free flaps from 1990 through 1998. By protocol, flap coverage was the reconstructive choice for defects with exposed tendons, joints, or bone. Local muscle flaps were selected over free flaps if the defect was small (3 x 6 cm or less) and within reach of the local muscle flap. During the same time frame, the authors performed 45 free flaps (96 percent success rate) in the same areas when the defects were too large or out of reach of local muscle flaps. Thirty-two consecutive patients underwent local muscle flap reconstruction for 19 diabetic wounds and 13 traumatic wounds. All wounds, after debridement, had exposed bone at their base, with osteomyelitis being present in 52 percent of the diabetic wounds and in 70 percent of the nondiabetic wounds. Wounds were located in the hindfoot (47 percent), midfoot (44 percent), and ankle (9 percent). Vascular disease was more prevalent in the diabetic group, in which 42 percent of the affected limbs required revascularization procedures before reconstruction (versus 7 percent in the nondiabetic group). Subsequently, 83 total operations were required to heal the wounds, of which 46 percent were limited to debridement only. Thirty-four pedicled muscle flaps were used: 19 abductor digiti minimi (56 percent), nine abductor hallucis (26 percent), three extensor digitorum brevis (9 percent), two flexor digitorum brevis (6 percent), and one flexor digiti minimi (3 percent). An additional skin graft for complete coverage was required in 18 patients (53 percent). One patient died and one flap developed distal necrosis, for a 96 percent success rate. The complication rate was 26 percent and included patient death, dehiscence, and partial flap or split-thickness skin graft loss. Twenty-nine of the 32 wounds healed. One patient died in the postoperative period; in two others the wounds failed to heal and required below-knee amputations, for an overall limb salvage rate of 91 percent. Diabetes did not significantly affect healing and limb salvage rates. Diabetes, however, did affect healing times (twofold increase), length of stay (2.7 times as long), and long-term survival (63 percent survival in diabetic patients versus 100 percent in the trauma group). Local muscle flaps provide a simpler, less expensive, and successful alternative to microsurgical free flaps for foot and ankle defects that have exposed bone (with or without osteomyelitis), tendon, or joint at their base. Diabetes does not appear to adversely affect the effectiveness of these flaps. Local muscle flaps should remain on the forefront of possible reconstructive options when treating small foot and ankle wounds that have exposed bone, tendon, or joint.