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Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: During laser-induced fragmentation, differences in assessing the intraoperative results can depend on the individual characteristics of the laser system used.Methods: Laser parameters like pulse energy and repetition rate, the penetration depth in silicon tissue, and the laser beam width on photographic paper were determined for three different clinical laser systems.Results: Pulse energy and repetition rate were subject to variations depending on the laser system employed. Significant differences between the three devices were found for penetration depth in silicon and interaction.Conclusions: Further investigations to ascertain the ablation threshold and fragmentation rate can be based on these findings. Intraoperative assessment of the lithotripsy results should take technical aspects of the laser equipment, stone consistency, and the surgeon's experience into consideration. [ABSTRACT FROM AUTHOR]

Sunitinib and Sorafenib are both effective angiogenetic inhibitors for the treatment of renal cell carcinoma. With these drugs of a new class of chronic therapy is performed. During chronic treatment, the inherent side effects may necessitate stopping the application of these drugs thus preventing the required effective therapy. Most of the effects can be avoided or attenuated by prophylaxis. In this paper the published data are reviewed and added with our experience in 138 patients over up to two and a half years. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to describe the adaption of 3D-navigation for interstitial brachytherapy. The new method leads to prospective and therefore improved planning of the therapy (position of the needle and dose distribution) and to the possibility of a virtual simulation (control if vessels or nerves are on the pathway of the needle).Material and Methods: The EasyGuide Neuro navigation system (Philips) was adapted in the way, that needles for interstitial brachytherapy were made connectable to the pointer and correctly displayed on the screen. To determine the positioning accuracy, several attempts were performed to hit defined targets on phantoms. Two methods were used: "free navigation", where the needle was under control of the navigation system, and the "guided navigation" where an aligned template was used additionally to lead the needle to the target. In addition a mask system was tested, whether it met the requirements of stable and reproducible positioning. The potential of applying this method in clinical practice was tested with an anatomical specimen.Results: About 91% of all attempts lied within 5 mm. There were even better results on the more rigid table (94% < 4 mm). No difference could be seen between both application methods ("free navigation" and "navigation with template"), they showed the same accuracy.Conclusions: The accuracy of the phantom experiments and the confirmation by the experiment with the anatomical specimen showed that excellent results can be expected in clinical practice using rigid tables and patient supporting systems. [ABSTRACT FROM AUTHOR]

Unlabelled: The separation of whole blood into components is the state-of-the-art in transfusion of allogeneic blood. The main reasons are the negative effects of the buffy coat and the need for FFP. Nevertheless, especially in Germany whole blood is being rejected more and more even as autologous blood. However, most of the negative effects of the buffy coat do not apply to autologous blood. Additionally, these patients usually do not develop coagulation disorders and therefore do not need plasma as a hemostatic component. On the other hand, separation into components of autologous blood leads to an increase of costs and to logistic problems that restrict autologous blood predeposit to a few institutions. Therefore, we have reviewed the literature in order to find a scientific basis for this.Methods: We analysed all articles listed by MEDLINE during the last 12 years that dealt with the quality of whole blood or red cell concentrates. In addition, all references were included that contributed relevant information to the topic. A total of 135 original articles, abstracts, reviews, letters or editorials were analysed that referred to standard preparations and storage media. In 48 papers the in vivo red cell survival was studied. 28 of which fulfilled the prerequisites to be included into a meta-analysis. The following in vitro parameters were also evaluated: pH, potassium load of the units, ATP and DPG concentration of the red cells.Results and Discussion: Whole blood (resuspended in CPDA-1) and red cell units (stabilized in CPDA-1 or additive solutions) with a different buffy coat or leucocyte content have comparable pH values and red cell 2,3-DPG and ATP concentrations at the end of the approved storage time. The potassium load of a whole blood unit appears to be higher than red cell concentrates, but this is to some extent caused by the higher plasma content of whole blood and is not thought to be a clinically relevant problem for patients receiving only a few units. A number of studies demonstrate that dependent upon the leucocyte content of a red cell unit, leucocyte metabolites and enzymes are released and accumulate during storage. A detrimental influence on the integrity of the red cell membrane was found in several in vitro studies. Nevertheless, a significant improvement in red cell survival by leucocyte reduction was detected by only one group. Undoubtedly, nonhemolytic febrile transfusion reactions (NHFTR) are generally caused by an antibody-antigen interaction due to the transfusion of allogeneic buffy coat. On the other hand, there is some evidence that non-specific immunological mechanisms such as the release of histamine or cytokines are also capable of causing NHFTR. Thus, these reactions are expected to occur in autologous blood transfusion. However, so far, there are no data about the frequency and severity of these reactions and whether they are more likely to emerge after transfusion of blood units with a particular preparation. Blood transfusions can cause septic complications due to bacterial contamination of the transfused units. These fatal but rare complications may be reduced by pre-storage filtration of blood, but there is no indication that buffy coat reduction is effective. Three cases with septic complications have been reported after autologous transfusion, in two of which red cell concentrates (at least one was free of buffy coat) had been used. Thus, there is no justification for the conclusion that the risk of septic complications is increased by transfusion of whole blood. After all, whole blood and red cell concentrates exhibit only minor differences in relevant in vitro parameters. Hence, a higher incidence of adverse effects following the transfusion of autologous whole blood compared to autologous red cell concentrations is unlikely. Therefore, the 24 h in vivo recovery is considered to be the most valid criterion to assess the quality of red cell preparations.(ABSTRACT TRUNCATED) [ABSTRACT FROM AUTHOR]

Copyright of Anaesthesist is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HeilberufeSCIENCE is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Judgement of image quality and detail recognition of digitized and post-processed portal films presented on a computer monitor compared to the present standard, conventional portal films presented on a light box.Materials and Methods: Conventional portal films of 3 different tumor sites (10 pelvis, 10 cranium, 10 vertebral column) were presented to a panel of 8 observers in 3 different matters: conventional film presented on a light box (Conv), digitized post-processed images (Dig-1) and digitized post-processed images (Dig-2) presented on a high resolution computer monitor. Subjective judgement of image quality, detailed recognition and time requirement of conventional films compared to monitor presentation were evaluated using a 5-scaled questionnaire (from 1 = much better to 5 = much worse). Furthermore the observers had to point out predefined anatomical bony structure on the conventional films (Conv) as well as on the digitized post-processed images (Dig-2). Standard deviations of the landmark outlined by 10 different observers were used as a criterion of objective detail recognition (Figure 1).Results: Image quality of digitized post-processed images presented on the computer monitor was judged statistical significant better than that of conventional films (pelvis 78%, vertebral column 62%, cranium 45% better) (Figure 3). Similar results were found for comparison of detail recognition: digitized post-processed images were scored better for pelvis in 81%, for vertebral column in 57%, for cranium in 40% (Figure 4, Table 1). Most benefit from portal film enhancement was found for pelvic images, where portal films are known to be of poor image quality (Figure 2). In contrast image quality of non-processed digital images compared to conventional films was graded worse (pelvis 69%, vertebral column 53%, cranium 71% worse) (Figure 4). Digital post-processed images were especially for the pelvis judged to require less time (pelvis 68%, vertebral column 26%, cranium 8% less time requirement) (figure 5). For the pelvis a statistical significant decrease of standard deviations was found for Dig-2 compared to conventional films, indicating an objective increase of image quality and detailed recognition (Table 2). In case of vertebral column and cranium no significant differences were evaluated (Table 3).Conclusions: Digitized enhanced portal films presented on a computer monitor resulted in a quicker assessment and equal to better image quality as well as detail recognition compared to conventional films. Non-processed digitized images were judged to be of less image quality. [ABSTRACT FROM AUTHOR]