Thrombosis of the aorta abdominalis in infants--diagnosis and thrombolytic therapy

Aortic thrombosis is rarely observed in neonates and infants. Underlying conditions include the presence of umbilical artery catheters, thrombosed aneurysm of the ductus arteriosus, sepsis and different states of inherited thrombophilia. Treatment options include anticoagulation, thrombolytic therapy and thrombectomy. Due to the lack of large studies, neither diagnosis nor treatment of neonatal aortic thrombosis are standardized.From 2008-2010, 1 neonate and 1 infant were admitted to our hospital with symptomatic aortic thrombosis.In both patients, diagnosis was made by Doppler ultrasound. Both patients were effectively treated with recombinant tissue type plasminogen activator. Diagnosis and treatment of 2 infants with symptomatic aortic thrombosis are discussed and the literature is reviewed.Since aortic thrombosis is a life-threatening condition, early diagnosis by Doppler ultrasound is mandatory to initiate treatment without delay. Thrombolytic therapy is a safe measure to treat this condition if administered with caution and if the patient has not suffered from serious complications such as mesenteric infarction or renal failure prior to begin of therapy.

The influence of testosterone substitution on bone mineral density in patients with Klinefelter's syndrome

The aim of this study was to clarify the extent of bone mineral deficiency in patients with Klinefelter's syndrome on the premise that testosterone substitution could prevent this deficiency. Bone mineral density was measured by single-photon absorptiometry in 42 patients with Klinefelter's syndrome, (21 patients without therapy, 10 with testosterone substitution before the age of 20 and 11 patients with testosterone substitution beginning after the age of 20). We found significantly lower bone mineral density in patients without therapy and in patients when the therapy began later compared to normal individuals. Patients with early therapy showed a high proportion of normal values of bone mineral density. We found a positive correlation between bone mineral density and plasma testosterone and a negative correlation between plasma testosterone and age for patients without therapy. These findings suggest that low testosterone levels before or during puberty cause inadequate bone development and low bone mineral density in Klinefelter's syndrome. Only early testosterone substitution may prevent bone mineral deficiency. Later substitution no longer affects bone mineral density.

Time-related effects of thyrotropin-releasing hormone (TRH) on the pituitary-thyroid axis and extrathyroidal targets

Thyrotropin-releasing hormone (TRH) is a tripeptide and acts as a stimulator of the pituitary-thyroid axis as well as having a great number of well defined extrathyroidal functions. Studies in experimental animals have shown, that TRH also has a role as a neuromodulator within the autonomous nervous system. In this study we analyzed the effects following peripheral administration of TRH (200 micrograms, 400 micrograms) in patients with endocrinological disorders and in healthy females and males. By means of a questionnaire, patients were asked about possible (side-) effects; ventilatory and cardiovascular monitoring was performed during steady state. The pulsatile TSH-secretion pattern was analyzed and thyroid and stress hormones were measured in the blood prior to and following TRH i.v. Frequent symptoms afer TRH were feeling of heat (58%), stimulation of respiration (61%), palpitations (39%), micturition urge (52%) and restlessness (32%). Apparative monitoring demonstrated a short stimulation of respiration and an increase of heart rate. After 400 micrograms TRH i.v., blood levels of ACTH decreased slightly (p less than 0.01) but levels of T3, T4, epinephrine, norepinephrine and cortisol remained unchanged (p greater than 0.05). TSH-levels were low during daytime and showed a surge at night.

Prevalence of exfoliation syndrome in Finland

Three separate investigations are reported, covering a total of 795 patients from different parts of Finland, two of them consisting of inmates of old people's homes in two towns (N = 205 and 262) and one a randomly selected population from a rural commune (N = 328). They show the mean prevalence of exfoliation syndrome (PS) to be 14.2% in age group 60 less than or equal to 69 years, 21.9% in age group 70-79 and 34.7% in age group greater than or equal to 80. The prevalence increases statistically significantly with age. The mean prevalence of PS in all three groups was 22.4%. No isolate-like accumulation of PS could be demonstrated. The figures seem representative of the hole country.

Histopathology of clinically successful intraocular lens implant

A 50-year-old man had an intracapsular cataract extraction with placement of a Worst medallion iris-supported lens. After 6 days postoperatively the eye appeared quiet, the cornea was clear and the implant in place. The patient died 17 days postoperatively of subarachnoid haemorrhage. Histopathological examination revealed slight loss of endothelial cells in the upper corneal region, pressure atrophy without signs of repair of the iris stroma, loss of pigment epithelial cells of the iris in places as well as local pigment epithelial cell proliferations. The chamber angle was open and the anterior uvea revealed only a minimal inflammatory cell reaction. The unoperated opposite eye showed cortical cataract as well as advanced hypertensive retinopathy.