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  • 1
    ISSN: 1433-0466
    Keywords: Schlüsselwörter Röntgenfunktionsanalyse nach Arlen • HWS-Distorsion • Simulanten
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Aufgrund der anhaltenden Diskussion um die medizinische und gesellschaftliche Problematik von HWS-Distorsionen und deren Folgen für die Patienten schien es von Interesse, die Daten der Röntgenfunktionsanalysen vor und nach indirektem HWS-Trauma zu vergleichen. Untersucht wurden daher Patienten, bei welchen wir aus früheren Untersuchungen im Besitz einer Röntgenfunktionsanalyse nach Arlen waren und die innerhalb von 30 Monaten Opfer eines indirekten HWS-Traumas wurden. Es wurden spontane (nicht gehaltene) Röntgenfunktionsaufnahmen in sagittaler Richtung (Bild in Neutralhaltung des Kopfes, in maximaler willkürlicher Extension sowie maximaler Flexion) durchgeführt und die Bewegungsamplituden der einzelnen Wirbelkörper statistisch ausgewertet. Dabei zeigte sich ein statistisch signifikanter Unterschied für die Gesamtamplitude sowie die Extensionsamplitude in den Segmenten C2, C4 und C6. Parallel wurde eine Serie von 10 Röntgenfunktionsanalysen von freiwilligen Kollegen ausgewertet. Das Ziel dieser Untersuchung war der Vergleich der Röntgenfunktionsanalyse unter Berücksichtigung der Arlen'schen Kriterien mit einer weiteren Analyse, bei der eine HWS-Dysfunktion nach einem zufällig ausgewählten Szenario simuliert werden sollte. Die Ergebnisse zeigen, daß es weitaus schwieriger ist, eine Pathologie vorzutäuschen, als von Experten angenommen wird. Beispielhaft werden bei einem Patienten die Röntgenfunktionsanalyse von Sponatanaufnahmen im Vergleich zu gehaltenen Aufnahmen vorgestellt und diskutiert. Dabei konnte eine Verschlechterung der Werte der Segmente aufgezeigt werden, die bereits nach den spontanen Aufnahmen als pathologisch aufgefallen waren.
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  • 2
    ISSN: 1433-0385
    Keywords: Key words: Hemorrhoidal disease ; Anal fissure. ; Schlüsselwörter: Hämorrhoidalleiden ; Analfissur.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Mit einer bundesweit unter coloproktologisch tätigen Ärzten durchgeführten Umfrage wurden Konzepte und Kontroversen in der Behandlung von Hämorrhoidalleiden und Analfissuren erhoben. Unter den 261 Umfrageteilnehmern befinden sich sowohl klinisch tätige als auch niedergelassene Proktologen, wodurch der aktuelle Stand und das gesamte Spektrum der Behandlungsformen vertreten sind. Neben einer üppigen Therapievielfalt bestehen auch deutlich unterschiedliche und z. T. widersprüchliche Behandlungskonzepte. Kontroversen zeigen sich sowohl in der Beurteilung der diversen konservativen Therapieformen als auch in der Indikationsstellung und Verfahrenswahl der operativen Therapie. Eine wissenschaftliche Klärung bestehender Kontroversen und damit eine größere Einheitlichkeit in Diagnostik und Therapie sind anzustreben.
    Notes: Summary. A survey among coloproctologists was performed to assess current therapeutic concepts for the treatment of hemorrhoidal disease and anal fissure. A total of 261 clinical and non-clinical proctologists participated, representing the entire range of therapies in hospital and practise. A wealth of widely differing, in some aspects contradictory concepts were recorded, leaving almost no subject entirely undisputed. There are controversies regarding the different therapeutic alternatives as well as indications for surgery and choice of operative procedure. Future research has to address the existing controversies in order to reach a higher degree of standardization in the therapy of these common proctological disorders.
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  • 3
    ISSN: 1432-2129
    Keywords: Schlüsselwörter Extrakorporale Stoßwellen ; Muskeldysfunktion ; Infantile Zerebralparese ; Key words Extracorporeal shock waves ; Muscular dysfunction ; Infantile cerebral palsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Introduction: Extracorporeal shock waves (ESW) are being used increasingly frequently for the treatment of narrowly localized pain in the musculoskeletal system. Pain is normally associated with muscular dysfunction. Beginning with the observation that not only is the pain soothed by treatment with ESW, but that the muscular dysfunction itself is relieved, an attempt has been made to treat the impaired function in cases of infantile cerebral palsy with ESW. Method: In 35 children and young people with mainly spastic disturbances of movement, the bellies of those muscles producing the flexion contracture of the lower limb were each treated with 500 non-focused pulses of low-energy ESW. The focus (focal pressure 10 MPA=0.06 mJ/mm) of the shock waves itself was placed either within the coupling cushion of the therapy source (Minilith, Storz Medical, CH-Kreuzlingen) or obliquely outside the patient’s body. In this way ESW could be dispersed throughout the muscles and the risk of undesirable effects was minimized. The energy used amounted to about 30% of the threshold value at which cellular damage from focused treatment with ESW had been observed in the endothelium of the human umbilical cord. Results: The degree of movement at the hip joint increased after one treatment by an average of 17°, at the knee joint by 12.3° and at the ankle joint by 7.1°, each increase being statistically significant. Muscular stiffness, spastic co-contractions, and myofascial viscoelasticity, as well as dyskinetic and ataxic symptoms, decreased. It appeared as if a systemic action had entered into the motor control. Together with an increase in general proprioception, there was an improvement in body image, in economy of movement and also in the limbs that had not been treated. A few patients showed euphoric reactions for about 2 days after treatment. No undesirable effects were observed during a follow-up of 12 months. The treatment was painless and is therefore suitable for children. The biomechanical improvement remained for several weeks and this time could be used for initiating an improved pattern of movement. Conclusion: ESW is suitable for use as an additional instrument for physiotherapeutic treatment of infantile cerebral palsy. The effective action of ESW on disturbed peripheral muscles has been discussed in terms of positive pressure and tensile wave forces and/or forces acting by cavitation. The results obtained in this pilot investigation showed particular a decrease in muscle stiffness. A controlled investigation with gait analysis and psychological control is to be undertaken.
    Notes: Zusammenfassung Bei 35 Kindern und Jugendlichen mit hauptsächlich spastischen Bewegungsstörungen wurden die Muskelbäuche der Beugekontrakturen verursachenden Muskeln der unteren Extremitäten mit jeweils 500 Impulsen niedrigenergetischer extrakorporaler Stoßwellen bei einem Fokusdruck von 10 MPa= 0,06 mJ/mm flächig behandelt. Der Fokus der Stoßwellen wurde außerhalb des Körpers der Patienten plaziert. Die angewandten Energien befanden sich bei 30% des Schwellenwerts, bei dem zellulare Schädigungen nach fokussierter Behandlung mit ESW am Endothel humaner Nabelschnüre beobachtet wurden. Der Bewegungsumfang der Hüftgelenke nahm durchschnittlich um 17°, der Kniegelenke um 12,3° und der Sprunggelenke um 7,1° bereits nach einer Behandlung jeweils statistisch signifikant zu. Spastische Kokontraktionen, muskuläre Steifigkeit und myofasziale Viskoelastizität nahmen ebenso wie dyskinetische und ataktische Symptome ab. Über eine Steigerung der allgemeinen Propriozeption kam es zur Verbesserung der Senso- und Psychomotorik. Die Behandlung ist schmerzfrei. Die biomechanischen Verbesserungen halten mehrere Wochen an. Die Zeit kann zur Anbahnung verbesserter Bewegungsmuster genutzt werden. Einige der Patienten gaben eine euphorisierende Wirkung von ca. 2 Tagen Dauer nach der Behandlung an. Unerwünschte Wirkungen wurden nicht beobachtet.
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  • 4
    ISSN: 1432-0568
    Keywords: Co-distribution ; Neurochemical evolution ; Primates ; Species specificity ; Distribution patterns
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The regional and laminar distributions of eight different transmitter-binding sites were measured in the marmoset hippocampus by means of quantitative in vitro receptor autoradiography. Receptors for 5-HT1, l-glutamate, N-methyl-d-aspartate (NMDA) and GABAA were similarly distributed. The highest concentrations of these receptors were found in the pyramidal layer of CA1 and the molecular layer of the dentate gyrus. The 5-HT2 receptors showed the highest concentrations in the oriens layer of CA2. The highest concentrations of muscarinic M1 receptors were seen in the pyramidal layer of CA1. Muscarinic M2 receptors were most densely concentrated in the pyramidal layers of CA1, CA2 and CA3. The noradrenergic α1 receptors were most densely packed in the radiatum-lacunosum-molecular layer of CA2 and the molecular layer of the dentate gyrus. Statistically significant co-distributions of serotoninergic, glutamatergic and GABAergic receptors point to possible interactions between these receptor systems in the same hippocampal regions and layers. Comparisons of marmoset distribution patterns for GABAA, NMDA, l-glutamate and 5-HT1 receptors with those in human hippocampi and those of other primates showed similarities between them. Clear differences in the patterns of α1, M1, M2 and 5-HT2 receptors could be seen between marmoset and human hippocampi, indicating a high degree of species specificity in a presumably “conservative” brain region. More similarities, however, could be found between marmoset and human hippocampi than between those of rat and human brains, especially in relation to 5-HT1 and GABAA receptors and l-glutamate-binding sites. In addition to the functional significance of receptor distribution patterns, such studies represent a valuable tool for the analysis of neurochemical aspects of brain evolution.
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  • 5
    ISSN: 1090-6533
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract Results are presented from the first experiments on interferometric enhanced scattering (IES) in a plasma in a nonuniform magnetic field. Measurements of the lower hybrid fluctuations of the plasma density by the IES and rf probe methods in an experimental geometry that models a tokamak configuration are found to be in satisfactory agreement.
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  • 6
    ISSN: 1615-6110
    Keywords: Anthurium sanguineum ; pollination ; hummingbirds ; montane rain forest ; Colombia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract Species ofAnthurium presumably are pollinated by insects. In the montane rainforests of western Colombia we recorded eight species of hummingbirds paying regular visits to the nectar-producing inflorescences ofAnthurium sanguineum. At peak-floweringA. sanguineum plays an important role in the birds' nutrition. Pollen is deposited on the tip of the birds' bills, indicating that pollination by hummingbirds occurs frequently. As no other flower visitors were recorded, we consider hummingbirds the main pollinators toA. sanguineum.
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  • 7
    ISSN: 1617-4623
    Keywords: Agrobacterium tumefaciens ; fixNOQP operon ; respiration ; cytochromec oxidase ; Rhizobiaceae
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract Hybridization analysis using theRhizobium meliloti nitrogen fixation genefixN as a probe revealed the presence of a homologous DNA region in the phytopathogenic bacteriumAgrobacterium tumefaciens. Hybridization signals were also detected with total DNAs ofRhizobium leguminosarum bv.phaseoli, Rhodobacter capsulatus andEscherichia coli, but not those ofXanthomonas campestris pv.campestris andPseudomonas putida. The hybridizing fragment fromA. tumefaciens was cloned and sequenced. The predicted gene product of one of the two open reading frames identified on the sequenced fragment shows homology to FixN of differentRhizobiaceae as well as a low but significant similarity to subunit I of heme copper oxidases from various bacteria. The presence of five strictly conserved histidine residues previously implicated in forming ligands to heme and CuB in oxidases and the predicted membrane topology provide evidence that theA. tumefaciens fixN-like gene product is a component of the heme copper oxidase superfamily. The incomplete open reading frame starting only 8 nucleotides downstream of thefixN-like gene exhibits homology toRhizobium fixO. Using anuidA (GUS) gene fusion it could be shown that theA. tumefaciens fixN-like gene is preferentially expressed under microaerobic conditions. Expression of theuidA fusion is abolished inR. meliloti fixJ andfixK mutants, indicating that an Fnr-like protein is involved in transcriptional regulation of thefixN-like gene in A.tumefaciens. The presence of an upstream DNA sequence motif identical to the Fnr-consensus binding site (anaerobox) further supports this hypothesis.A. tumefaciens mutated in thefixN-like gene shows decreased TMPD-specific oxidase activity under microaerobic conditions, indicating that thefixN-like gene or operon codes for proteins involved in respiration under reduced oxygen availability.
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  • 8
    ISSN: 1612-1112
    Keywords: Capillary electrochromatography ; Packing materials ; Mixed-mode phase ; Active ingredients and preservatives in creams ; Cortisone derivatives
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Summary Capillary electrochromatography (CEC) is an analytical method of growing interest to the pharmaceutical industry. Because CEC is a combination of high-performance liquid chromatography (HPLC) and capillary electrophoresis (CE) it has the advantages of the high selectivity of HPLC and the high efficiency of CE. The capillaries can be packed with different packing materials. The mixed-mode phase consisting of a strong cation exchanger and alkyl chains on the silica surface has some advantages over conventional reversed-phase (RP) packing materials. In this article the authors describe the use of CEC to separate the active ingredients and preservatives in creams from different manufactures. On the basis of the high efficiency of CEC it was possible to develop one isocratic method for all the compounds in the different samples. The method was validated with regard to identification, reproducibility, linearity, limit of detection, and quantitation.
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  • 9
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Au cours d'une étude prospective, nous avons examiné la valeur de l'échographie endorectale (ERUS) dans la détermination pré-opératoire du stade des tumeurs susceptibles d'être excisées localement. Au cours d'une période allant du 1er janvier 1991 au 1er mars 1995, sur un total de 160 tumeurs rectales, 152 ont fait l'objet d'une détermination endosonographique de leur stade (uT/uN) et ont été comparées avec les résultats postopératoires de l'histologie (pT/pN) à l'Hôpital universitaire de Wurzburg. Trente-huit patients (24%) étaient porteurs d'un adénome et 15 (9%) d'un cancer au stade T1. Chez 29 patients (18%) le diagnostic retenu est d'un cancer au stade T2; de plus, 67 (42%) et 11 patients (7%) patients étaient respectivement porteurs d'une tumeur au stade T 3 et T 4. La sensibilité pour les adénomes et les cancers au stade T1 (uT0/1) était de 81% avec une spécificité de 98%. Pour les tumeurs au stade T2, la sensibilité n'était que de 41% et la spécificité de 92% étant donné que la majorité des cancers au stade pT2 (17/29) ont été surestimés (uT3). L'exactitude du stade globalement était (T1 – 4) de 77,5%. Deux patients avec un cancer pT1 et 7 avec un cancer pT2 présentaient des métastases ganglionnaires qui avaient été diagnostiquées en pré-opératoire chez 5 d'entre eux. L'exactitude dans la mise en évidence de ganglions lymphatiques est de 83%. Nous concluons que les adénomes et les tumeurs au stade T1 peuvent être diagnostiqués avec une très grande exactitude au moyen de l'échographie endo-rectale. Dans ces tumeurs, l'échographie peut être utilisée comme aide au diagnostic et au choix thérapeutique (opération par voie transanale versus opératoire par voie abdominale). En raison du manque des sensibilité , l'échographie n'ait d'aucune aide dans la détermination des cancers au stade T2.
    Notes: Abstract. In a prospective study we examined the value of endorectal ultrasound (ERUS) in the preoperative staging of potentially locally excisable tumours. During the study period from 1.1.1991 to 1.3.1996 a total of 160 rectal tumours in 152 patients were staged endosonographically (uT/uN) and compared postoperatively with the histologic result (pT/pN) at the University Hospital of Würzburg. Thirty-eight (24%) patients had an adenoma and 15 (9%) a T1-carcinoma. In 29 (18%) cases a T2-cancer was diagnosed, further 67 (42%) and 11 (7%) patients presented with a T3 and T4 tumour, respectively. The sensitivity for adenomas and T1-Ca (uT0/1) was 81%, the specificity 98%. For T2 tumours the sensitivity was only 41% and the specificity 92% as the majority (17 of 29) of pT2 neoplasias were overstaged (uT3). The overall staging accuracy (T1 – 4) was 77.5%. Two patients with a pT1-Ca and seven with a pT2-Ca had lymph node metastases which were detected preoperatively in five. The accuracy for lymph node staging was 83%. We conclude that adenomas and T1 tumours can be assessed with a high grade of accuracy using ERUS. In these tumours ERUS can be used to assist clinical decision-making (transanal vs. abdominal operation). Owing to the lack of sensitivity, ERUS is of no help in the assessment of T2 carcinomas.
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  • 10
    ISSN: 1432-2099
    Keywords: Key words Normal tissue ; Minipig ; Lung ; Heavy particles ; Carbon ionsIntroduction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Physics
    Notes: Abstract  The response of pig lungs to irradiation with 12C-ions was assessed in two experiments to validate the procedures for heavy ion therapy planning at the Gesellschaft für Schwerionenforschung (GSI) and to explore their range of applicability. In both experiments, the target volume (spread-out Bragg peak, SOBP) was planned to be a 4 cm long cylinder with a diameter of 4 cm. Doses in the SOBP were prescribed to be equivalent to 5×4 Gy, 5×5.5 Gy and 5×7 Gy of x-rays in the first experiment, and to 5 fractions of 7 Gy and 9 Gy in the second experiment. The lung response in the first experiment was less than expected on the basis of earlier experiments with photons. Pneumonitis reaction and chronic fibrotic changes were observed outside the prescribed high-dose region. In the second experiment, the effects were more pronounced than had been expected on the basis of the first experiment. Changes were most intense in the high-dose region, but were also seen throughout the lung along the beam channel. Moreover, significant skin reactions were observed at the beam entrance site in all animals and – less pronounced – at the beam exit site in 3 of the 6 animals. In conclusion, the complex irradiation geometry of the pig lung, the changes of body weight between the two experiments, and insufficient accounting for a change in the relative biological effectiveness (RBE) computation led to substantial deviations of the observed reactions from expectations, the reasons for which could be identified in a subsequent analysis. The less pronounced lung reaction in the first experiment was due to an overestimation of RBE in a preliminary version of the algorithm for its determination. The extension of the fibrotic reaction resulted from the smear-out of the high-dose region due to density variations in tissue structures, respiratory movement, and limited positioning accuracy. The skin reactions at the entrance port reflect the different treatment geometry in the two experiments. The one unexplained observation is the mild skin reaction that was observed in the second experiment at the beam exit site.
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