Search

Fifty-nine hip arthrographic roentgenograms were performed on 31 children with cerebral palsy (CP) and plain radiographic evidence of hip deformity. Five levels of hip instability were defined by the arthrographic migration index (MI). The incidence of femoral head deformation increased with an increase in MI. A new measurement, defined by the intersection of Hilgenreiner's line with a tangent drawn from the lateral cartilaginous acetabular anlage, decreased proportionally with the increase in the MI. These findings indicate that progressive deformation of the cartilaginous acetabulum and femoral head occurs during (and, in some cases, before) evolution of hip instability in patients with CP.

The Ravenspurn South Gas Field is located in the Sole Pit Basin of the Southern North Sea in UKCS Block 42/30, extending into Blocks 42/29 and 43/26. The gas is trapped in sandstones of the Permian Lower Leman Sandstone Formation, which was deposited by aeolian and fluvial processes in a desert environment. Reservoir quality is poor, and variations are mostly facies-controlled. The best reservoir quality occurs in aeolian sands wth porosities of up to 23% and permeabilities up to 90 md. The trap is a NW-SE-striking faulted anticline: top seal is provided by the Silverpit Shales directly overlying the reservoir, and by Zechstein halites. Field development began early in 1988 and first gas was delivered in October 1989. Production is in tandem with the Cleeton Field, about 5 miles southwest of Ravenspurn South, as the Villages project. Initial reserves are 700 BCF and field life is expected to be 20 years.

Leukotriene (LT) generation has been implicated in the pathogenesis of the acute respiratory distress syndrome, ARDS. In the present study, we analysed broncho-alveolar lavage fluids of patients on mechanical ventilation because of ARDS (17 samples taken from 9 patients) or because of cardiogenic edema (8 samples taken from 6 patients) and of healthy volunteers (10 samples from different donors). LTs were separated as methylated and non-methylated compounds using different HPLC procedures, and were identified by chromatographic mobility, on-line UV-spectrum analysis and post HPLC immunoreactivity. In the lavage samples of the healthy volunteers and the patients with cardiogenic edema, no LTs were detected by these techniques (detection limit congruent to 0.1-0.2 ng/ml lavage fluid). By contrast, in 15 out of 17 samples from patients with ARDS LTB4 or its metabolites 20-OH-LTB4 and 20-COOH-LTB4 were detected. The endproduct of omega-oxidation, 20-COOH-LTB4, represented the quantitatively predominant compound, detected in the range of 0.3-2.6 ng/ml perfusate. We conclude that the chemotactic agent LTB4 may be involved in the amplification of inflammatory events encountered in ARDS, and that the oxidized metabolites of LTB4 are particularly suitable for monitoring lung leukotriene generation under conditions of neutrophil efflux and oxidative stress.

The synthesis and properties of mononuclear vanadium complexes with Bu t S − ligation are reported. Treatment of VCl 3 (THF) 3 with NaSBu t and Bu t SSBu t in MeCN leads to high-yield isolation of V(SBu t ) 4 (1). In contrast, treatment of VCl 3 (THF) 3 with NaSBu t and 2,2'-bipyridine (bpy) leads to the V III salt [V(SBu t ) 2 (bpy) 2 ][V(SBu t ) 4 ] (2). Complexe 1 crystallizes in space group P42 1 c. Complex 2 crystallizes in space group P2 1 /n

Staphylococcus aureus remains the most common etiology of hematogenous osteomyelitis in children. Recently emerged virulent strains of methicillin-resistant S. aureus (MRSA) strains now predominate. It remains uncertain whether these pathogens cause a measurably more severe illness than methicillin-sensitive strains.We reviewed records of 97 pediatric patients with hematogenous osteomyelitis of varying etiologies to determine whether there were significant differences among the groups in terms of predetermined measures of disease severity. These measures included degree and duration of elevated temperature, acute-phase reactants, length of hospitalization, the number of surgical procedures required, and long-term sequelae.Differences in the clinical course of illness were observed. Patients with MRSA had a significant increase in degree and duration of elevated temperature (P = 0.0001 for both), acute-phase reactant measures (white blood cell count, P = 0.0001; C-reactive protein, P = 0.0058; erythrocyte sedimentation rate, P = 0.0046), initial length of hospital stay (P = 0.0001), and surgical interventions (all procedures, P = 0.0001; therapeutic procedures, only P = 0.0002) as compared with patients with osteomyelitis caused by other bacterial pathogens and culture-negative osteomyelitis. A similar general pattern was observed when the analysis was restricted to culture-positive staphylococcal cases only.Our results support the hypothesis that MRSA produces more severe bone infection and is likely to require more aggressive surgical and medical management.

Temperature measurements from the ALOMAR Weber Na lidar together with cosmic radio noise absorption measurements from IRIS and particle measurements from NOAA 15, 16 and 17 are used to study effects of geomagnetic activity on the polar winter upper-mesospheric temperature. On 21–22 January 2005 we have 14 h of continuous temperature measurement with the Na lidar coinciding with strong geomagnetic activity in the declining phase of one of the hardest and most energetic Solar Proton Event (SPE) of solar cycle 23. According to measurements by the imaging riometer IRIS in northern Finland, the temperature measurements coincide with two periods of increased cosmic radio noise absorption. Particle measurements from the three satellites, NOAA 15, 16 and 17 that pass through and near our region of interest confirm that the absorption events are probably due to particle precipitation and not due to changes in e.g. the electron recombination coefficient. The measured temperature variation at 85 and 90 km is dominated by a 7.6-h wave with downward phase propagation and a vertical wavelength of approximately 10 km. Assuming that the wave is due to a lower altitude source independent of the particle precipitation, we do not find any temperature modification that seems to be related to the absorption events. The average temperature is larger than expected above 90 km based on MSIS and the monthly mean from falling spheres, which could be due to particle precipitation and Joule heating prior to our measurement period. There is also a possibility that the identified wave phenomenon is an effect of the geomagnetic activity itself. Earlier studies have reported of similar wavelike structures in wind observations made by the EISCAT VHF radar during SPEs, and found it conceivable that the wave could be excited by the effect of energetic particles precipitating into the mesosphere.

Several possible mechanisms for the production of sporadic sodium layers have been discussed in the literature, but none of them seem to explain all the accumulated observations. The hypotheses range from direct meteoric input, to energetic electron bombardment on meteoric smoke particles, to ion neutralization, to temperature dependent chemistry. The varied instrumentation located on Andøya and near Tromsø in Norway gives us an opportunity to test the different theories applied to high latitude sporadic sodium layers. We use the ALOMAR Weber sodium lidar to monitor the appearance and characteristics of a sporadic sodium layer that was observed on 5 November 2005. We also monitor the temperature to test the hypotheses regarding a temperature dependent mechanism. The EISCAT Tromsø Dynasonde, the ALOMAR/UiO All-sky camera and the SKiYMET meteor radar on Andøya are used to test the suggested relationships of sporadic sodium layers and sporadic E-layers, electron precipitation, and meteor deposition during this event. We find that more than one candidate is eligible to explain our observation of the sporadic sodium layer.

We present summer Na-densities and atmospheric temperatures measured 80 to 110 km above the Arctic Lidar Observatory for Middle Atmosphere Research (ALOMAR). The Weber Na Lidar is part of ALOMAR, located at 69° N in Norway, 150 km north of the Arctic Circle. The sun does not set here during the summer months, and measurements require a narrowband Faraday Anomalous Dispersion Optical Filter (FADOF). We discuss an observed sudden enhancement in the Na number density around 22:00 UT on 1 to 2 June 2006. We compare this observation with previous summer measurements and find a frequent appearance of Na number density enhancements near local midnight. We describe the time of appearance, the altitude distribution, the duration and the strength of these enhancements and compare them to winter observations. We investigate possible formation mechanisms and, as others before, we find a strong link between these Na number density enhancements and sporadic E layers.

[Au 2 (C 5 H 10 NS 2 ) 2 ] cristallise dans I4 1 /a avec a=18,060, c=22,914 A, Z=16; affinement jusqu'a R=0,037. Dans cette structure, les dimeres contiennent chacun deux atomes Au portes par deux coordinats diethyldithiocarbamate. La distance intramoleculaire Au−Au est de 2,782 A; les longueurs Au−S s'etendant entre 2,28 et 2,30 A. Du fait de l'empilement de ces dimeres, des chai←nes lineaires d'atomes Au sont constituees, contenant la plus petite distance intermoleculaire Au−Au (3,004 A) jamais trouvee dans un complexe dithiocarbamate d'or

Subacute osteomyelitis is a chronic low-grade infection of bone characterized by a lack of systemic manifestations. The onset is insidious. Pain is the most common symptom, and has usually been present for several months before the initial evaluation. Swelling and tenderness over the area of involved bone may also be seen. Laboratory evaluation is unrevealing, with a normal white blood cell count and differential. The erythrocyte sedimentation rate may also be normal. The most common organism cultured from a subacute osteomyelitis is a staphylococcus species. Twenty-five percent of subacute bone infections are sterile. The most common manifestation of a subacute osteomyelitis in a child is a geographic lytic metaphyseal lesion (Brodie's abscess). Treatment of a culture positive infection includes surgical debridement and antibiotic therapy. A sterile abscess can be treated conservatively without antibiotics, provided the patient's symptoms are improving and the lesion is regressing radiographically.

Large dynamically stressed forgings in nuclear and conventional power stations constitute a high risk potential if flaws are present and must therefore be subjected to ultrasonic inspection. Since flaws frequently cannot be repaired, it is important to determine their size for an appraisal of component integrity by fracture mechanics. By the example of large rotation-symmetrical forgings with manufacturing flaws, the possibilities and limits of evaluating the ultrasonic findings are described.

Type II Monteggia lesion equivalents produced by plastic deformation of the ulna are rare. Radial head fractures in skeletally immature patients are also uncommon. We report a late presentation of a Type II Monteggia equivalent injury with a fracture of the radial head and neck and plastic deformation of the ulna in an 11-year-old boy. The radial head was located on the initial injury radiographs and subsequently dislocated in a posterior direction. The radial head fracture was misdiagnosed as a coronoid fracture at presentation. The plastic deformation of the ulna was diagnosed several weeks after the injury when the dislocation was first noted. Magnetic resonance imaging was used to establish the diagnosis of a radial head fracture at the same time. The patient was treated successfully with an open reduction and internal fixation of the radial head combined with a dorsal closing-wedge ulnar osteotomy.

We present the clinical, radiologic, histologic, immunohistochemical, and ultrastructural characteristics of a congenital pretibial subcutaneous lesion composed of a mixture of T and B cells, epithelial cells, and dendritic cells, probably representing a hamartoma. After total removal, there has been no recurrence. The prominent dendritic component of this lesion, demonstrated immunohistochemically and ultrastructurally, separates the lesion from cutaneous lymphadenoma and other adnexal tumors.

Childhood sarcoidosis is a disease with multisystem organ involvement, and initial presentation as fever of unknown origin (FUO) is relatively common. We describe herein three children (aged 9, 7, and 11 years) with sarcoidosis who were seen initially with FUO. Common clinical and laboratory features include fever of > 2 weeks' duration, weight loss, fatigue, leg pain, anemia, increased erythrocyte sedimentation rate, elevated immunoglobulin G level, negative antinuclear antibodies and rheumatoid factor, and negative purified protein derivative and Candida skin tests. Two patients had iridocyclitis, one had hilar adenopathy, and two had angiotensin-converting enzyme serum levels. All three had no evidence of pulmonary infiltrates on chest radiographs. Bone marrow biopsies for all three were normal, and with no evidence of malignancy. Plain radiographs of the lower extremities and bone scan were normal. Magnetic resonance imaging (MRI) of the lower extremities revealed intact bone architecture and multifocal nodular lesions within the marrow. Bone biopsy from the tibia performed on two patients showed normal bone trabeculae and a solitary noncaseating epithelioid cell granuloma. Noncaseating granuloma was found on reevaluation of the bone marrow biopsy in the third patient. All three patients had negative marrow stains and cultures for fungi and mycobacteria. We conclude that MRI was very useful in the diagnosis of sarcoidosis in children with FUO.

Giant cell tumor of the tendon sheath (nodular synovitis) is a benign soft tissue tumor, usually affecting older women, that most often occurs in the interphalangeal joints of the fingers. Occurrence is rare in children. We present a 12-year-old boy and a 6-year-old girl with giant cell tumors of tendon sheaths occurring in the toes. The tumor from the 12-year-old demonstrated the cytogenetic finding of t(1;2)(p13;q37), which previously has been associated with giant cell tumor of tendon sheath in adults. Giant cell tumors of the tendon sheath occurring in children have similar histological and cytogenetic features as adults, however, there may be a predilection for lower extremity involvement.

Cytogenetic studies were performed on an alveolar soft part sarcoma of a 6-year-old boy. An extra chromosome 8 was present in 26 of 28 metaphases analyzed.

There are highly divergent data on the body m a s s (mb) of Brachiosaurus (B.). The range of the body-mass estimations lies between 14900 and 102000 kg for this giant dinosaur [1-6] . This is mainly due to the fact that different specimens and varying techniques are used for the volume (V) estimations, such as equations from the circumferences of femur and humerus [4] or from the volume of models [5]. The precise determination of Vis important for calculating the body surface area (SA) as well as for allometric equations, which are often based on Mb. Herewith, we present a photogrammetric method to determine the metrical dimensions of giant sauropods such as B. The data presented here are based on the skeleton of B. brancai from the Upper Jurassic of Tendaguru (East Africa, Tanzania), mounted and exhibited at the Museum of Natural History in Berlin (Germany). The major part of the skeleton belongs to one single specimen of B. brancai recovered from the Middle Saurian Bed at Tendaguru. The tail originates from another individual of the same species of similar size found in the Upper Saurian Bed. In addition, skeletal remains of B. brancai excavated in different sites in the surroundings of the Tendaguru hill were used for the mounting, partly original and partly modeled. The presacral vertebral column (cervicals, dorsals) and the skull have been replaced by plaster copies modeled from originals of the main skeleton due to their extreme fragility and weight. The right shoulder blade, four dorsal ribs, and some bones of the left forefoot have been modeled in plaster according to counterparts of the other body side. Some missing elements are substituted by bones belonging to individuals of the same size such as the right ilium, the right ischium, and the left lower leg. Other missing items have been replaced by originals (e.g., left femur) or copies of bones from different-sized animals (e.g., sacrum, most hindfoot bones). At the very end of the tail four small pieces were added. Like the missing first caudal vertebra, most of the hemapophyses (chevrons) are plaster imitations [6]. As can be seen in Fig. 1, we divided the presumable shape of B. brancai into XI parts. Each part was separately calculated and the Vi-xi are given in Table 1. From the V found, the Mb was calculated assuming a density of 1000 kg per m 3 tissue [5, 7]. On the basis of the above findings, we investigated further whether the presumable organ volumes derived by allometric equations could be fitted into the anatomical dimensions given by the skeleton. The advantage of the photogrammetrical approach is that when the values are taken from a specimen, the complete shape of the animal is stored in the computer. This allows later derivation of other forms and dimensions, which is almost impossible from a model. In the case of a small model being built from the data and later becoming enlarged, the smallest deviation is multiplied by a factor of 10-50 depending on the size of the model. Therefore, regardless of the size of a model, it is defined by these exact basal metric values. The anatomical data of B. brancai derived by stereophotogrammetry and the presumable physiological data calculated after equations given for endotherms are summarized in Table1, Table2, and Fig. 2. According to these, the Mb of B. braneai is ca. 74420 kg (skeleton 11480 kg). Accordingly, the M b estimations in [1] are similar to our findings, whereas those in [2, 4 6 ] are far too low. It is not clear whether the estimation in [3] for B. refers to the Berlin specimen. If so, it is far too high. The S A (Table 2) was found to be at least (without any skin

Necrotizing sarcoid granulomatosis (NSG) is characterized by pulmonary nodular infiltrates, a typical histology, and a benign clinical course. The etiology and pathogenesis of the disease are still unknown. In childhood, it is extremely rare, with only three reported cases so far. Here we report on an 8-year-old girl, who to our knowledge is the youngest reported patient with NSG. The girl presented with shortness of breath and a sore throat. Chest X-ray and computed tomography (CT) scan revealed multiple nodular opacities of the lung. The symptoms and radiological findings disappeared within 6 months without any treatment. The diagnosis was based on the typical signs and symptoms of NSG and on the exclusion of other diseases. As abnormal immunological findings such as the lack of specific diphtheria antibodies in spite of vaccination against diphtheria were present, we suggest that immunologic mechanisms could play an etiologic role in the pathogenesis of NSG. In addition, the ratio of CD4+/CD8+ T-cells in the peripheral blood was significantly reduced, whereas the CD4+/CD8+ T-cell ratio in the immunohistochemical staining of the lung tissue was elevated. Since this compartmentalization is a typical finding in sarcoidosis, it supports the theory that NSG may represent a variant of sarcoidosis. However, because some characteristics of NSG are uncommon in typical sarcoidosis, NSG may also be an entity in its own right.

Due to the introduction of a variety of new features to the German health system, such as a new reimbursement system for inpatient work based on diagnosis-related groups, an obligation to detailed documentation for total quality management, as well as due to the continuing increase in the amount of imaging and other data within invasive cardiology, the use of electronic databases for documentation in the cardiac cath lab is of significant importance. The user friendliness and robustness of the software system for daily clinical practice is crucial for the acceptance of electronic documentation systems by physicians, nurses and technicians. This survey was aimed to explore the current practice and experiences of German cardiac catheterization labs with electronic databases particularly designed for documentation in invasive cardiology, including report generation of cath studies, risk and complication management and logistics for medical material ordering for the cath lab. Of the 176 hospitals and practices having agreed in taking part in this surveillance 165, are currently using an electronic database for administration of medical data and study reports. In 64% of the cath labs, a sub-specialized software system for detailed documentation of the course and the results of an invasive procedure, the human and material resources used, generation of the cath report, and documentation of procedural and post-procedural complications for total quality management is used. The acceptance and satisfaction with the software solutions currently available reveals to be rather inhomogeneous. While user-friendliness and flexibility of a number of software products were positively mentioned, main issues, such as missing hardware of software interfaces with the hospital information system for patient administration, missing stability of several systems, image management too complex and report configuration too inconvenient for daily clinical practice, were criticized. In general, in the light of continuing increase of the amount of clinical and imaging data as well as due to the legal obligation of detailed procedural documentation in all areas of invasive cardiology, a documentation system based on electronic databases bears the potential of an enormous economization of the daily workload of a cardiac cath lab. Prerequisites for the acceptance of such a system in clinical practice is not only the stability and reliability of the system but also the ability to link such a sub-system to existing databases via suitable interfaces and the flexibility of the system for modification of its features to meet the individual requirements of each user.

The Pura-Vario stent features 2 newly designed "bridging segments" for enhanced longitudinal flexibility, in order to allow easier and safer stent implantation.The aim of the present experimental investigation was to analyze the expansion characteristics of the Pura-Vario stent (PV), and to compare it with the Palmaz-Schatz stent (PS). Furthermore, stent implantation using "high pressure" (18 atm) (HP) was compared with "normal pressure" (12 atm) (NP). Stents (n = 16) were implanted into the left anterior descending artery (LAD) and the circumflex artery (CX) of 8 pigs. Stent area, lumen area and stent asymmetry were measured by means of three-dimensional intravascular ultrasound (3D-IVUS): (1) immediately after implantation, and (2) at 14-days follow-up.Stent expansion was found not to be uniform: the "bridging segments" were significantly larger than the "diamond segments" in either stent model at day 0; this difference, however, disappeared at 14-days follow-up. Despite higher flexibility of the Pura-Vario stent, no difference in stent expansion was found between both stent models, neither immediately after implantation (mean lumen area: 9.75 +/- 0.28 mm2 (PV) vs. 9.82 +/- 0.34 mm2 (PS)), nor at 14-days follow-up (7.44 +/- 0.16 mm2 (PV) vs. 7.45 +/- 0.22 mm2 (PS)). Pura-Vario stents, however, were less asymmetric in the cross-sectional view. Implantation using "high pressure" resulted in larger and less asymmetric stent expansion only at day 0 (lumen area: 9.54 +/- 0.39 mm2 (HP) vs. 8.77 +/- 0.33 mm2 (NP) (p0.05)); this difference, however, disappeared after 14 days due to higher stent recoil in the "high pressure" group.Despite higher flexibility of the Pura-Vario stent, expansion characteristics of both stent models were comparable. "High pressure" implantation compared favorably with "normal pressure" implantation only at day 0, whereas no difference could be found between both techniques at 14-days follow-up.

An 11-year-old boy developed florid reactive periostitis several years after minor trauma. The symptoms responded initially to antibiotics, but after cessation, rapidly recurred and progressed, requiring a ray amputation to relieve the pain and to achieve a functional hand. The reactive periostitis affected the volar aspect of two adjacent phalanges with sparing of the intervening joint, confirming that this is a reactive process rather than a benign neoplasm.

The prebiopsy evaluation of a child with a musculoskeletal neoplasm is the cornerstone for all subsequent treatment. A better understanding of the natural history of pediatric musculoskeletal tumors and an explosion in the development of sensitive new imaging modalities have significantly advanced the care of the child with a musculoskeletal pathologic condition. This article details the prebiopsy clinical and radiographic evaluation of the child or adolescent with a musculoskeletal neoplasm.

The variety and distribution of skeletal lesions in children with acute lymphoblastic leukemia is rarely seen in other diseases. Skeletal radiographic changes that can occur in a child with acute leukemia include diffuse osteopenia, metaphyseal bands, periosteal new bone formation, geographic osteolysis, osteosclerosis, mixed osteolysis and sclerosis, and permeative destruction. It is important for orthopedic surgeons to recognize the skeletal manifestations of acute leukemia of childhood because the physician who initially evaluates the child will often be an orthopedic surgeon, and a delay in diagnosis has an adverse affect on survival.

Acute annular ligament interposition into the radiocapitellar joint ("nursemaid's elbow") is a common injury in children younger than 5 years. The injury occurs when axial traction is applied to an extended, pronated arm. There are no abnormal radiographic findings associated with this condition. We recommend that children with a classic history and clinical presentation of an acute annular ligament interposition into the radiocapitellar joint be treated without obtaining radiographs.

The treatment of chronic hepatitis B and C with recombinant interferon (IFN) has only poor durable response rates. In the past only the lack of any prior effective therapy regimen could justify the use of this expensive agent. Dose escalating or prolonged treatment courses did not enhance the rate of sustained remissions. Pre- or cotreatment with antiviral (e.g. acyclovir, ribavirin, isoprenosin) or immunomodulating (e.g. prednisone, gamma IFN) drugs have not influenced the resistance to exogenous (IFN) of many patients. The mechanisms underlying resistance to this drug remain unknown. Some hypotheses focus on IFN antibodies, down regulation of IFN receptors or defects in the postreceptor response of cells to IFN. In 1991 Hannigan and Williams (Science 1991; 251: 204-207) described a synergistic signal transduction effect in human fibroblasts after exposure to IFN. Arachidonic acid (AA) activation from membrane phospholipid pools is common to many receptors and can be followed by metabolization of AA by cyclooxygenase to prostanoids, thromboxanes and eicosanoids and by lipoxygenase to leukotrienes; inhibition of these AA oxidation pathways by addition of inhibitors of these enzymes (e.g. indomethacin) resulted in marked amplification of the IFN signal, possibly by using the epoxygenase enzyme family as an alternative pathway. Our data are taken from the pretreatment part of a current study for evaluation of pre- and combination treatment with acetylsalicylic acid (ASA) as cyclooxygenase inhibitor and IFN in chronic hepatitis C. 27 patients with histologically proven chronic active hepatitis C were divided into two groups. Group A (16 patients) were treated with a daily dose of 100 mg ASA orally, and the 11 patients in group B served as untreated controls.(ABSTRACT TRUNCATED AT 250 WORDS)

We present a case report (with review of the literature) of a 3-year-old child who was struck by an automobile, sustaining a superior quadrant pelvic fracture that involved the sacroiliac joint, the adjacent ilium, and the acetabulum. This was successfully treated by open reduction and fixation with cannulated screws.

We describe a child with features of the Beckwith—Wiedemann syndrome with congenital recurrent digital fibroma of infancy that extended into and replaced the marrow of the terminal phalynx of the little finger. Digital fibromas of infancy have not previously been associated with either Beckwith—Wiedemann syndrome or invasion into underlying bone.

Two patients with advanced ovarian cancer (FIGO III C) and one patient with abdominal cancer developed severe thrombocytopenia with petechial haemorrhages after chemotherapy. These patients were treated with recombinant human interleukin-3 (rhIL-3) after multiple platelet transfusions (HLA-matched) and erythrocyte transfusions had not been effective. Increase of thrombocyte counts began three days after rhIL-3 therapy. Side effects due to rhIL-3 administration (flu-like symptoms) were moderate and could be treated effectively with paracetamol. These data support evidence for efficacy of rhIL-3 in chemotherapy-induced thrombocytopenia and may open new therapeutic perspectives.

Overall survival benefit and impact on skeletal-related events for radium-223 chloride (Alpharadin) in the treatment of castration-resistant prostate cancer (CRPC) patients with bone metastases : A phase III randomized trial (ALSYMPCA)

Femur fractures represent approximately 1.7% of all pediatric bony injuries. Most femur fractures were treated nonoperatively prior to the early 1980s. Recent refinements in the operative techniques used to treat pediatric femur fracture have led to a reduction in the use of traction and casting treatment methods.

Gastric outlet obstruction by a gallstone is a very uncommon clinical entity; it was first reported by Bouveret in 1896. In the patient presented, we were able to show the development of formation of the bilioenteric fistula with massive arterial bleeding from the eroded cystic artery until duodenal occlusion. The process was endoscopically and radiologically observed and documented. Although the diagnosis was made immediately, the patient had to undergo surgery because the gallstone proved to be too large to be extracted endoscopically.

The structure is reported of bones of glacial-period mammals, which were found in 1973 to 1989 in gravel-sandy soil of the fossiliferous layer "Rixdorfer Horizont" at Niederlehme near Königs Wusterhausen. The findings, probably, date from one of the interstages of the glacial period "Weichsel-Kaltzeit" before the stage "Brandenburger Stadium". Their embedding took place more than 20,000 years ago. Changes of the deposit of bones and teeth from older sediments are not to exclude in the finding place Niederlehme. In the collection of findings with 102 skeletal parts are to define following species: Mammuthus primigenius, Coelodonta antiquitatis, Equus sp., Bison priscus, Megalocerus giganteus, Cervus elaphus, Rangifer tarandus and Canis lupus. A trajectorial direction of the trabecula in the substantia spongiosa is evident. There are also specific channels of blood vessels with different diameters. This channels have completely closed bone-wall (with a central venous sinus of diameter 5 to 10 mm) or in little vessels (diameter 1 to 3 mm), we have found many apertures to the rooms of the substantia spongiosa. The microscopical investigation of bones of Mammuthus primigenius has shown Havers' channels and perforating channels, Havers' systems and lacunae osseae.