PRE- AND PERINATAL DEVELOPMENT OF THE CANINE CLAW

Deckblatt-Impressum persönlicher Dank Inhaltsverzeichnis Abkürzungsverzeichnis Einleitung Literaturübersicht Material und Methoden Befunde Diskussion Zusammenfassung Summary Abbildungen Literaturverzeichnis Anhang Danksagung Lebenslauf SelbständigkeitserklärungFür die Untersuchung der PRAE- UND PERINATALEN ENTWICKLUNG DER HUNDEKRALLE standen 19 Tiere mit einer Scheitelsteißlänge (SSL) zwischen 44 mm und 220 mm sowie vier Tiere bis einschließlich eine Woche post natum zur Verfügung. Zum Vergleich wurden weiterhin Krallen von vier adulten Hunden untersucht. Neben der makro- und mesoskopischen Untersuchung der Kralle wurden lichtmikroskopische Routinefärbungen sowie histochemische und rasterelektronenmikroskopische Methoden angewandt. Unter Berücksichtigung der Entwicklung subkutaner und dermaler Gefäßstrukturen sowie der Ausbildung segmentspezifischer Strukturen des Papillarkörpers und der Oberhaut wird die Entwicklung der Hundekralle in drei Phasen eingeteilt. Die ersten beiden Entwicklungsphasen spielen sich prae- und perinatal ab, während die dritte Phase für die juvenile und adulte Hundekralle gilt. Die ERSTE PHASE umfasst Foeten mit einer SSL von 44 mm bis zu einer SSL von 80 mm (30. bis 42. Trächtigkeitstag). Sie ist gekennzeichnet durch die Ausbildung des subkutanen Gefäßplexus sowie des tiefen dermalen Gefäßplexus, während der Papillarkörper noch weitgehend undifferenziert und damit noch nicht segmentspezifisch geformt ist. Dabei ist besonders auffallend, dass der subkutane Gefäßplexus im praesumptiven Wand- und Sohlensegment von Knochengewebe umschlossen wird und damit in den äußeren Teil des Krallenbeinfortsatzes integriert wird. Die ZWEITE PHASE umfasst Foeten mit einer SSL größer als 80 mm (44. Trächtigkeitstag) und endet nach den Ergebnissen dieser Untersuchung eine Woche post natum. Neben der vollständigen Entwicklung subkutaner und tiefer dermaler Gefäßstrukturen steht in der zweiten Entwicklungsperiode der Hundekralle die Ausformung eines segmentspezifischen Papillarkörpers in Verbindung mit der Ausbildung oberflächlicher dermaler Gefäße sowie der weiteren Differenzierung der Epidermis im Vordergrund. Die DRITTE PHASE berücksichtigt die juvenile und adulte Hundekralle nach der Ausbildung segmentspezifischer Gefäßplexus und nach der Ausformung des segmentspezifischen Papillarkörpers. Sie ist besonders gekennzeichnet durch die funktionell bedingte adaptive Differenzierung der einzelnen Strukturen innerhalb der Unter-, Leder- und Oberhaut. Die Ergebnisse dieser Untersuchung zur prae- und perinatalen Entwicklung der Kralle ermöglichen eine Neubewertung der HOMOLOGIEKRITERIEN für eine Segmenteinteilung der Hundekralle: 1\. Entwicklung, Ausprägung und Abgrenzung von praesumptiver Subkutis und Dermis anhand der Ausbildung spezifischer Gefäßstrukturen (primäres Homologiekriterium) 2\. Entwicklung des segmentspezifischen Papillarkörpers (sekundäres Homologie¬kriterium) 3\. Entwicklung der segmentspezifischen Epidermis unter Einbeziehung der Hornbbildungsrate (tertiäres Homologiekriterium) Daraus ergibt sich für die Hundekralle eine Segmenteinteilung entsprechend derjenigen der Zehenendorgane von Pferd und Rind in ein SAUM-, KRON-, WAND-, SOHLEN- und BALLENSEGMENT. Als vergleichbare Strukturen zum Fußungsapparat von Pferd und Rind bilden sich auch innerhalb der Kralle entsprechende, wenn auch weitaus weniger stark spezialisierte Strukturen aus. Der Vergleich zur Katzenkralle macht deutlich, dass beide Krallenformen obwohl Fleisch¬fresserkrallen doch deutliche funktionelle sowie strukturelle Unterschiede aufweisen. Diese Differenzen veranschaulichen die Notwendigkeit der getrennten Betrachtung von Hunde- und Katzenkralle. Während die Kralle als phylogenetische Urform des Zehenendorganes der Säuger angesehen werden darf, lassen die strukturellen Unterschiede beider Fleischfresserkrallenformen vermuten, dass die Katzenkralle die phylogenetisch ältere Form bildet und damit die Hundekralle die weiter differenzierte Form der Fleischfresserkralle darstellt. Die Ergebnisse dieser Arbeit stellen eine Ergänzung des Basiswissens über die Hundekralle dar und sollten bei der Beurteilung gesunder und kranker Hundekrallen berücksichtigt werden.The investigation of the PRE- AND PERINATAL DEVELOPMENT OF THE CANINE CLAW presented in this study was based on 19 canine specimens ranging from a crown rump length (CRL) of 44 mm to 220 mm, and on four neonate puppies aged up to one week. For comparison of the developing claw structures with those of the mature claw, four claws of adult dogs were included into the scope of the study. Besides macro- and mesoscopic examination, routine light microscopical staining and histochemical techniques as well as scanning electron microscopy were employed for characterisation of the claw specimens. Taking the development of subcutaneous and dermal angioarchitecture as well as the formation of segment-specific modifications of the papillary body and the respective epidermal structures into account, the developmental processes involved in the formation of the canine claw were subdivided into three different stages. The first two developmental stages take place within the pre- and perinatal period, whereas the third stage describes the adaptive processes of the juvenile and adult claw. The FIRST STAGE comprises fetuses of 44 mm CRL up to a CRL of 80 mm (day 30 to 42 of pregnancy). This stage is characterised by formation of the subcutaneous and the profound dermal vascular plexus, whereas the dermal papillary body appears mostly undifferentiated and thus not yet region-specifically modified. It is of particular interest that the subcutaneous plexus of the presumptive wall and solear segment is covered by ossified tissue layers and thus integrated into the peripheral part of the unguicular process of the distal phalanx. The SECOND STAGE of claw development comprises fetuses of more than 80 mm CRL (day 44 of pregnancy) and, according to the present study, ends one week post natum. Alongside with the definite formation of the subcutaneous and deep dermal vascular plexus, the development of a segment-specific dermal papillary body associated with the formation of respective epidermal modifications dominate this stage of claw development. The THIRD STAGE regards the structural alterations of the juvenile and adult claw after the development of the segment-specific papillary body. It is characterised by function-related adaptive modifications of the subcutaneous, dermal and epidermal layers of the claw. The results of this study regarding the pre- and perinatal development of the claw allowed a reappraisal of the HOMOLOGY CRITERIA employed for the allocation of the different segments of the canine claw: 1\. Development, specifity and differentiation of presumptive subcutaneous and dermal layers, respectively, according to the formation of specific angioarchitectural features (primary homology criterion) 2\. Development of the dermal segment- specific papillary body (secondary homology criterion) 3\. Development of the segment-specific epidermal modifications under consideration of the respective horn-production rate (tertiary homology criterion) Thus, the segment- allocation of the canine claw corresponds with the respective segments of the digital end organs in the horse and cattle, i.e., PERIOPLIC, CORONARY, WALL, and BULBAR SEGMENT. Comparable to the highly derived weight-bearing apparatus in the equine hoof and bovine claw, the canine claw likewise features corresponding - but not as highly specialised - weight-bearing-associated structures. In comparison with the feline claw, it is apparent that both types, i.e., feline and canine, of the carnivore claw, display distinct functional and structural differences. Therefore, the canine and the feline claw have to be considered separately. Whereas the carnivore claw is generally regarded as the primary phylogenetic type of the mammalian digital end organ, the apparent structural differences between feline and canine carnivore claw lead to the assumption that the feline claw is the primary type of carnivore claw, and the canine claw, in turn, represents a more derived type of carnivore claw. The results of the present study contribute to and expand the basic knowledge on the structure of the canine claw, and should therefore be considered in the future evaluation of physiological and pathologically altered structures of the claws in dogs

Adverse Drug Reactions in a Complementary Medicine Hospital: A Prospective, Intensified Surveillance Study

Background. Anthroposophic medicine is one of the widely used approaches of complementary and alternative medicine. However, few prospective studies have generated safety data on its use. Objectives. We aimed to assess adverse drug reactions (ADRs) caused by anthroposophical medicines (AMEDs) in the anthroposophical Community Hospital Havelhoehe, GERMANY. Study Design and Methods. Between May and November 2007, patients of six medical wards were prospectively assessed for ADRs. Suspected ADRs occurring during hospitalization were documented and classified in terms of organ manifestation (WHO SOC-code), causality (according to the Uppsala Monitoring Centre WHO criteria), and severity. Only those ADRs with a severity of grade 2 and higher according to the CTCAE classification system are described here. Results. Of the 3,813 patients hospitalized, 174 patients (4.6%) experienced 211 ADRs (CTCAE grade 2/3 n = 191, 90.5%, CTCAE grade 4/5 n = 20, 9.5%) of which 57 ADRs (27.0%) were serious. The median age of patients with ADRs (62.1% females) was 72.0 (IQR: 61.0; 80.0). Six patients (0.2%) experienced six ADRs (2.8% of ADRs) caused by eight suspected AMEDs, all of which were mild reactions (grade 2). Conclusion. Our data show that ADRs caused by AMEDs occur rarely and are limited to mild symptoms

Is it possible to recover information from the black-hole radiation?

In the framework of communication theory, we analyse the gedanken experiment in which beams of quanta bearing information are flashed towards a black hole. We show that stimulated emission at the horizon provides a correlation between incoming and outgoing radiations consisting of bosons. For fermions, the mechanism responsible for the correlation is the Fermi exclusion principle. Each one of these mechanisms is responsible for the a partial transfer of the information originally coded in the incoming beam to the black--hole radiation. We show that this process is very efficient whenever stimulated emission overpowers spontaneous emission (bosons). Thus, black holes are not `ultimate waste baskets of information'.Comment: 9 pages (2 figures available upon request), CERN-TH 6811/93, (LateX file

Situations of stress experienced by nursing staff in the care of the potential organ donor

Objective: the objective is to identify situations of stress experienced by the members of the nursing staff of Intensive Care Unit to care for a potential organ donor. Method: Qualitative, exploratory and descriptive research, with fourteen members of the nursing staff who work with the potential organ donor. The data were collected through semistructured interviews and analyzed on the basis of the analysis of thematic content. Results: Health professionals feel threatened to identify with the situation of the person in brain death, by the fear of the death itself, with the doubt in relation to brain death and also because of the feeling of failure as a professional. Conclusion: The nursing staff in front of the potential organ donor comes under stressful situations, having to overcome the challenges and to mobilize strategies from the situations that are presented

Brazilian congresses - bridges to freedom and nursing transformation

This study concerns the comprehension of the converging points in Brazilian Nursing Congresses as well as of their contribution to the production of nursing knowledge. The investigation method used was that of historical research with a documental analysis of the Proceedings of Brazilian Nursing Congresses from 1977 to 1987. The main converging points appearing in the lecturers' speeches refer to: higher and secondary education; nursing care; healthcare policies; the image of nurses and its transformation over the years.El estudio trata sobre la comprensión de los puntos de convergencias en los Congresos Brasileños de Enfermería y la forma como se presentan, contribuyendo para la producción del conocimiento en Enfermería. El método de investigación utilizado fue la pesquisa histórica, con análisis documental de las publicaciones de los Congresos Brasileños de Enfermería en el período de 1977 a 1987. Los principales puntos de convergencia presentes en los discursos de los conferencistas se relacionan con: educación superior y de nivel medio; atención de enfermería clínica y de salud pública; políticas de salud y la imagen de la enfermera/o y sus transformaciones a lo largo de los años.O estudo trata da compreensão dos pontos de convergências dos Congressos Brasileiros de Enfermagem e a forma como se apresentam na produção do conhecimento em Enfermagem. O método de investigação utilizado é a pesquisa histórica, com análise documental dos Anais dos Congressos Brasileiros de Enfermagem no período de 1977 a 1987. Os principais pontos de convergência presentes nos discursos dos palestrantes referem-se a: educação superior e de nível médio; assistência de enfermagem hospitalar e de saúde pública; políticas de saúde e; a imagem da/o enfermeira/o e suas transformações ao longo dos anos

Successful treatment of metastatic uveal melanoma with ipilimumab and nivolumab after severe progression under tebentafusp: a case report

Metastatic uveal melanoma (UM) is a rare form of melanoma differing from cutaneous melanoma by etiology, prognosis, driver mutations, pattern of metastases and poor response rate to immune checkpoint inhibitors (ICI). Recently, a bispecific gp100 peptide-HLA-directed CD3 T cell engager, tebentafusp, has been approved for the treatment of HLA-A*02:01 metastatic or unresectable UM. While the treatment regime is complex with weekly administrations and close monitoring, the response rate is limited. Only a few data exist on combined ICI in UM after previous progression on tebentafusp. In this case report, we present a patient with metastatic UM who first suffered extensive progression under treatment with tebentafusp but in the following had an excellent response to combined ICI. We discuss possible interactions that could explain responsiveness to ICI after pretreatment with tebentafusp in advanced UM

The molecular hallmarks of primary and secondary vitreoretinal lymphoma

Vitreoretinal lymphoma (VRL) is a rare subtype of diffuse large B-cell lymphoma (DLBCL) considered a variant of primary central nervous system lymphoma (PCNSL). Diagnosis of VRL requires examination of vitreous fluid, but cytologic differentiation from uveitis remains difficult. Due to its rarity and difficulty in obtaining diagnostic material, little is known about the genetic profile of VRL. The aim of our study was to investigate the mutational profile of a large series of primary and secondary VRL. Targeted next generation sequencing using a custom panel containing the most frequent mutations in PCNSL was performed on 34 vitrectomy samples of 31 patients with VRL and negative controls with uveitis. In a subset of cases, genome-wide copy number alterations (CNA) were assessed using the Oncoscan platform. Mutations in MYD88 (74%), PIM1 (71%), CD79B (55%), IGLL5 (52%), TBL1XR1 (48%), ETV6 (45%) and 9p21/CDKN2A deletions (85%) were the most common alterations, with similar frequencies in primary (15), synchronous (3) or secondary (13) VRL. This mutational spectrum is similar to MYD88mut/CD79Bmut (MCD or cluster 5) DLBCL with activation of Toll-like and B-cell receptor pathways and CDKN2A loss, confirming their close relationship. Oncoscan analysis demonstrated a high number of CNAs (mean 18.6/case). Negative controls lacked mutations or CNAs. Using cell free DNA of vitreous fluid supernatant, mutations present in cellular DNA were reliably detected in all examined cases. Mutational analysis is a highly sensitive and specific tool for the diagnosis of VRL and can also be applied successfully to cell free DNA derived from the vitreous.Copyright © 2021 American Society of Hematology

Alcoolismo e a produção científica da enfermagem brasileira: uma análise de 10 anos

Trata-se de uma pesquisa documental cujo objetivo foi refletir sobre o alcoolismo como objeto de conhecimento da enfermagem brasileira, a partir das teses e dissertações publicadas sobre a temática no período de 1977 a 2007. A fonte de pesquisa foi o Banco de Teses e Dissertações da Associação Brasileira de Enfermagem aonde foram identificados 43 estudos. A análise dos dados teve duas etapas: primeiro, realizou-se uma caracterização dos trabalhos, posteriormente, organizou-se o material a partir dos dados evidentes nos estudos, originando as seguintes categorias temáticas: o imaginário sobre o alcoolista; o álcool e o adolescente; o tratamento do alcoolismo; e alcoolismo feminino. Constatou-se que os estudos propiciaram apreender os aspectos do contexto psicossocial, tão importantes e necessários no sentido de se olhar mais atentamente a prática assistencial que se presta ao alcoolista nos serviços de saúde do Brasil. Descritores: Pesquisa em enfermagem; Álcool; Drogas; Alcoolismo