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Background: Sinus vein thrombosis is a rare intracerebral complication of mastoiditis. We report on the clinical ophthalmologic symptomatology of this secondary illness., History: two young female patients, aged 14 and 3.5 years, presented at our pediatric ophthalmology section due to diplopia. Both girls had suffered 1-2 weeks earlier from otitis media, which had been treated with antibiotics. Other neurological symptoms were not reported., Clinical Course: Best corrected visual acuity was 20/20 OD/OS in both patients. Ocular alignment revealed a bilateral abduction deficit in the 14-year-old girl and a monolateral abduction deficit of the right eye in the younger patient. Ophthalmoscopic examination evidenced bilateral papilledema in both patients. Magnetic resonance tomography and magnetic resonance angiography showed mastoiditis and thrombosis of the sigmoid and transverse sinuses., Therapy: Following mastoidectomy, high-dose antibiotic therapy, and full-dose heparin therapy, rapid improvement occurred., Conclusions: Thrombosis of the sigmoid sinus following mastoiditis is a rare but severe complication of middle ear inflammation. Immediate surgical and antibiotic therapy is necessary. Symptoms can possibly occur even when the primary focus seems to resolve.

Background: Arteriovenous communications in which blood flows from meningeal branches of the internal and external carotid arteries into the venous circulation around and in the cavernous sinus are termed spontaneous (dural) carotid sinus cavernous fistulas. Due to their mostly low shunt volume they are rarely life threatening, but without treatment they may cause severe ocular complications like episcleral secondary glaucoma, central vein occlusion or exudative retinal detachment. Traditional therapy is the transarterial approach by an interventional neuroradiologist. If such an approach is not possible or unsuccessful a transvenous route has to be considered., Patients and Methods: Two patients underwent anterior orbitotomy via sub brow incision or infraciliary incision with cannulation of the superior ophthalmic vein or the inferior ophthalmic vein and embolization of the cavernous sinus with platinum coils., Results: Successful closure was achieved on angiography and normalisation of clinical symptoms after a short period of progressive venous congestion., Conclusions: For arteriovenous fistulas that cannot be embolized arterially the surgical transvenous orbital route may work as a method of second choice. When performed by an interdisciplinary team (orbital surgeon, interventionell neuroradiologist) it is a technically straightforward, effective and promising approach.

Background: Retinal microvascular abnormalities associated with multiorgan disease may be observed in a number of systemic illnesses and syndromes., Patients: Two sisters with identical signs of a hereditary cerebroretinal vasculopathy (occlusive retinal angiopathy--cerebral vasculopathy--microcephalus) were treated at the University Hospital of Saarland., Course: Photocoagulation for treatment of neovascular complications secondary to retinal ischemia was performed. In one eye a vitrectomy became necessary because of persistent vitreal hemorrhage. One sister died because of non treatable intracranial hypertension at the age of 22 years., Conclusions: Interdisciplinary work-up is important in patients with cerebroretinal disease. Neuropathologic evaluation including brain biopsy and neuroimaging plus ophthalmoscopy and pedriatic findings lead to the diagnosis of this rare hereditary, in this case most likely autosomal recessive condition. Photocoagulation may limit neovascular complications secondary to retinal ischemia. A specific form of treatment has, however, not yet been found.

Purpose: The study was undertaken to assess characteristic short-term CT and MR changes in brain tumors following 125I interstitial irradiation., Method: Sixteen patients were included who had both CT and MR control examinations at regular intervals over a period of 18 months following treatment. Two groups were distinguished: low grade tumors (11 cases) and high grade malignancies (5 patients). 125I seeds were used as temporary implants. The cumulative dose was 50-60 Gy., Results: In some patients of both groups, a low attenuation spheric structure with a contrast-medium-enhanced ring and a diameter of 6-8 mm was observed. There was no edema around the structure, which represents a zone of tissue necrosis at the site of the temporary 125I implant. Tumors in both groups were completely destroyed, some decreased in size, and others were unchanged. Pseudotumor necrosis with accompanying edema occurred in two patients with low grade astrocytoma, the diameter of which was > 4 cm., Conclusion: The behavior of cerebral tumors and their appearance on CT and MR images after interstitial irradiation seem to be variable. Decrease in tumor size may take place at different intervals after therapy. Brachytherapy of tumors with a diameter of > 4 cm may produce space-occupying radionecrosis.

For stable-xenon computed tomography (CT), an X-ray examination for measurement of cerebral blood circulation in the brain, the radiation exposure of the patient was determined in order to estimate the risk of inducing cancer. Organ doses of brain, eyelenses, thyroid and gonads have been calculated using the measured air kerma free-in-air on the axis of rotation and organ-specific conversion factors calculated with the Monte Carlo method. Dose measurements with TLD-100 rods using a humanoid Alderson phantom were carried out for verification of the calculated organ doses. In the case of brain partially located in the region of primary radiation a mean organ dose of 39 mSv was calculated. The dose measurements showed dose equivalents between 6 and 68 mSv in different regions of the brain and consequently an inhomogeneous dose distribution. From an estimation of the radiation-induced risk using the effective dose of 1.6 mSv it follows that one additional fatal cancer per 12,500 stable-xenon CT examinations has to be expected. The organ doses of eyelenses and thyroid located in the region of scattered radiation are so low that biological effects are hardly to be expected. The calculated dose equivalents of 6.5 mSv and 0.5 mSv, respectively, are in good agreement with measurements. The organ dose of gonads amounted to less than 0.07 mSv.

We describe the dose responses and dispersal of chromatid (ct) aberrations in human peripheral blood lymphocytes, treated with a 5-min pulse of bleomycin (BLM) in doses ranging from 0.78 to 200 micrograms/ml during the G2 phase of the cell cycle. Damage was assessed in cells fixed at the time of peak damage 1 h after treatment. Both ct breaks and the percentages of damaged cells rose according to log BLM dose above 6.3 micrograms/ml only. Below this dose all endpoints exhibited flat responses suggestive of thresholding. A dose of 100 micrograms/ml produced similar amounts and distribution of ct breakage per cell (B/c) as a previously studied X-ray dose of 0.8 Gy, permitting future direct cytogenetic comparisons between clastogens. Within the scorable range (0-29 B/c) the dispersal of ct breakage after BLM treatment resembled that after equivalent X-irradiation; but BLM treatment alone resulted in the formation of heavily damaged cells (HDC) defined as with > or = 30 B/c, representing a cytogenetic endpoint of DNA damage reminiscent of apoptosis. At the dose producing equivalent chromatid breakage, BLM produced 7.4 times fewer exchanges than X-rays in G2.

Mycoplasmal contamination remains a significant impediment to the culture of eukaryotic cells. For certain cultures, attempts to eliminate the infection are feasible alternatives to the normally recommended disposal of the contaminated culture. Here, three antibiotic regimens for mycoplasmal decontamination were compared in a large panel of naturally infected cultures: a 1-wk treatment with the fluoroquinolone mycoplasma removal agent (MRA), a 2-wk treatment with the fluoroquinolone ciprofloxacin, and three rounds of a sequential 1-wk treatment with BM-Cyclin containing tiamulin and minocyclin. These antibiotic treatments had a high efficiency of permanent cure: MRA 69%, ciprofloxacin 75%, BM-Cyclin 87%. Resistance to mycoplasma eradication was observed in some cell cultures: BM-Cyclin 0%, MRA 20%, ciprofloxacin 20%. Nearly all resistant contaminants that could be identified belonged to the species Mycoplasma arginini and M. orale. Detrimental effects of the antibiotics were seen in the form of culture death caused by cytotoxicity (in 5 to 13% of the cultures). Alterations of the cellular phenotypic features or selective clonal outgrowth might represent further untoward side effects of exposure to these antibiotics. Overall, antibiotic decontamination of mycoplasmas is an efficient, inexpensive, reliable, and simple method: 150/200 (75%) chronically and heavily contaminated cultures were cured and 50/200 (25%) cultures could not be cleansed and were either lost or remained infected. It is concluded that eukaryotic cell cultures containing mycoplasmas are amenable to antibiotic treatment and that a cure rate of three-quarters is a reasonable expectation.

Acetobacter methanolicus MB 70 was shown to be related to the type strain of this species MB 58/4 (IMET 10945) having the same galactan-->2)-beta-D-Gal f-(1-->3)-beta-D-Gal p-(1-->as the capsular polysaccharide (CPS) and the O-side-chain of the lipopolysaccharide (LPS). Additionally, a glucan built up of the disaccharide repeating unit-->6)-alpha-D-Glc p-(1-->2)-alpha-D-Glc p-(1-->was identified in strain MB 70. In the CPS, the polymers were present in the ratio approximately 1:1, whereas the glucan preponderated in the LPS. Bacteriophage Acm6 specific to A. methanolicus MB 70 hydrolysed selectively the glucan component of both CPS and LPS. Structural elucidation of the resulting oligosaccharides led to the identification of the phage-associated depolymerase as an endo-alpha-(1-->6)-D-glucopyranoside hydrolase.

The treatment of subarachnoid haemorrhage caused by aneurysm in comatose patients with or without midbrain symptoms is a matter of controversy. The question is, which comatose patients will profit from aneurysm surgery and which will not? In a retrospective study, 573 patients were examined between 1986 and 1992. Of these, 116 were in poor condition (Hunt and Hess Grade IV or V). The following management protocol was used: after computer tomography, a decision was made whether intensive medical treatment was performed or not. The reason for not operating was essentially the severity of the cerebral haemorrhage and poor or absent intracranial filling on angiography. Extracerebral causes were renal failure, sepsis, liver cirrhosis and pulmonary embolism. The direct early aneurysm operation was performed in the clinical deterioration phase in patients with space-occupying haematomas. In dilatation of the ventricle system, external drainage was initially positioned, in the case of bilateral haematocephalus, two-sided drainage was positioned, then intensive medical treatment and angiography were performed. The aneurysm operation was then ruled out if there was no clinical improvement. Aneurysm operation was performed on 57 of the 116 patients; 13 died, 32 showed a good and 12 a poor or fair outcome. 15 patients had mid-brain syndrome, and 5 of them died. Based on our experience, we draw the following conclusion: the Hunt and Hess scale alone is not a sufficient basis for decision taking. Some of the comatose patients, even in mid-brain syndrome, profit from an early operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Nuclear medicine techniques have been powerful tools in neurology since their introduction. Computed tomography, magnetic resonance imaging and newer techniques, i.e. MR spectroscopy and angiography, sonography, Doppler sonography and EEG mapping with squid elements have overtaken most earlier nuclear medicine techniques for neurological diagnosis. Positron emission tomography is the gold standard for in vivo research in neurophysiology and pathology. The introduction of SPECT and the development of such tracers as 99mTc-HMPAO (99mTc-d,l-hexamethylpropylenaminoxim) and, more recently, 123I-iomazenil and 123I-IBZM (123I-3-iodo-6-methoxybenzamide) allowed closer examination of the perfusion of the brain and neuroreceptor density mapping in more than the few institutions that can afford PET and the production of special tracers marked with a positron emitting nucleus. Nuclear medicine's future will be based on neuroreceptor density mapping, as further tracers will become commercially available and no other technique can probably show such low concentrations of the receptors. Probably MR techniques will be used for brain's perfusion measurement in future. For examination of a limited cerebral region xenon-enhanced CT is an alternative to perfusion measurements with HMPAO, or a very interesting supplement. Of the old techniques in nuclear medicine, examination of the liquor dynamics is still feasible and well supplemented by SPECT.

Methyl-coenzyme-M reductase (MCR) catalyzes the formation of methane from methyl-coenzyme M [2-(methylthio)ethanesulfonate] and 7-mercaptoheptanoylthreonine phosphate in methanogenic archaea. The enzyme contains the nickel porphinoid coenzyme F430 as a prosthetic group. In the active, reduced (red) state, the enzyme displays two characteristic EPR signals, MCR-red1 and MCR-red2, probably derived from Ni(I). In the presence of the substrate methyl-coenzyme M, the rhombic MCR-red2 signal is quantitatively converted to the axial MCR-red1 signal. We report here on the effects of inhibitory substrate analogues on the EPR spectrum of the enzyme. 3-Bromopropanesulfonate (BrPrSO3), which is the most potent inhibitor of MCR known to date (apparent Ki = 0.05 microM), converted the EPR signals MCR-red1 and MCR-red2 to a novel axial Ni(I) signal designated MCR-BrPrSO3. 3-Fluoropropanesulfonate (apparent Ki < 50 microM) and 3-iodopropanesulfonate (apparent Ki < 1 microM) induced a signal identical to that induced by BrPrSO3 without affecting the line shape, despite the fact that the fluorine, bromine and iodine isotopes employed have nuclear spins of I = 1/2, I = 3/2 and I = 5/2, respectively. This finding suggests that MCR-BrPrSO3 is not the result of a close halogen-Ni(I) interaction. 7-Bromoheptanoylthreonine phosphate (BrHpoThrP) (apparent Ki = 5 microM), which is an inhibitory substrate analogue of 7-mercaptoheptanoylthreonine phosphate, converted the signals MCR-red1 and MCR-red2 to a novel axial Ni(I) signal, MCR-BrHpoThrP, similar but not identical to MCR-BrPrSO3. The results indicate that inhibition of MCR by the halogenated substrate analogues investigated above is not via oxidation of Ni(I)F430. The different MCR EPR signals are assigned to different enzyme/substrate and enzyme/inhibitor complexes.

Thirty-nine continuous adherent or suspension cell lines were treated with a quinolone antibiotic, Mycoplasma Removal Agent (MRA), for the elimination of chronic mycoplasma contamination. In preliminary experiments MRA did not show any cytostatic or cytotoxic effects on mycoplasma-free cell cultures in concentrations up to ten-fold the concentration used for mycoplasma eradication. Twenty-eight cell lines (72%) were effectively cleansed of the mycoplasma contaminants by MRA treatment. The persistent removal of the mycoplasma infection was monitored by three mycoplasma detection assays. In seven cell lines (18%) the mycoplasmas were resistant to treatment with MRA. The resistant species was mainly M. arginini followed by M. orale and A. laidlawii; however, other cell lines harboring these species were cured. Four cell lines (10%) which prior to treatment presented with decreased viability and poor or no cell growth were lost during or shortly after the exposure to the antibiotic. If an antibiotic elimination is attempted it is imperative to closely examine the effectiveness of treatment and possible eukaryotic cytotoxicity. The treated mycoplasma-free cells may also no longer express the original features as a result of treatment or the absence of mycoplasma.

The sensitivity and specificity of five different mycoplasma detection tests were evaluated in comparison with the classical microbiological culture assay on agar plates as the reference method: direct fluorochrome DNA staining (direct DAPI), DNA staining of an indicator cell line (indirect DAPI), RNA hybridization with a cDNA specific for ribosomal mycoplasmal RNA, an enzyme-linked immunosorbent assay (ELISA) with mycoplasma-specific antibodies, and a biochemical cytotoxicity assay (6-MPDR). A large panel of continuous cell lines (20 adherent and 233 suspension cell lines, most of the latter were human leukemia-lymphoma cell lines) were analyzed for infection with mycoplasma. The results of the comparative analysis for sensitivity and specificity of the various tests were as follows: 100% and 100% for the indirect DAPI, 100% and 98% for the RNA hybridization assay, 87% and 94% for the direct DAPI, 72% and 100% for the ELISA, 75% and 90% for the biochemical 6-MPDR assay. Each of these approaches has both advantages and disadvantages with regard to cost, time, reliability, specificity, and sensitivity. The best compromise for routine mycoplasma testing is a combination of several techniques (e.g. direct culture on agar, RNA hybridization, and direct or indirect DAPI).

Methyl-coenzyme-M reductase from Methanobacterium thermoautotrophicum (strain Marburg) was purified to a stage where, besides the alpha, beta and gamma subunits, no additional polypeptides were detectable in the preparation. Under appropriate conditions the enzyme was found to catalyze the reduction of methyl-CoM with 7-mercaptoheptanoylthreonine phosphate (H-S-HTP) to CH4 at a specific rate of 2.5 mumol.min-1.mg protein-1. This finding contradicts a recent report that methyl-CoM reductase is only active when some contaminating proteins are present. The two polypeptides encoded by the open reading frames ORF1 and ORF2 of the methyl-CoM reductase transcription unit did not co-purify with the alpha, beta and gamma subunits. They were neither required nor did they stimulate the activity under the assay conditions. 3-Bromopropanesulfonate (apparent Ki = 0.05 microM) and 2-azidoethanesulfonate (apparent Ki = 1 microM) were found to be two new competitive inhibitors of methyl-CoM reductase. Both inhibitors were considerably more effective than the "classical" 2-bromoethanesulfonate (apparent Ki = 4 microM).