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Im Beitrag wird das Konzept der Alltagskommunikation vorgeschlagen, welches darauf abzielt, die komplexe zwischenmenschliche Kommunikation in der digitalen Gesellschaft kontextualisiert zu analysieren. Das Konzept verortet die von unterschiedlichen Medien geprägten, mobilen und mitunter parallel verlaufenden Kommunikationsprozesse mit anderen Menschen in der Alltagswelt eines Individuums. Es begreift diese Prozesse als miteinander in Beziehung stehend, in überdauernde Strukturen der zwischenmenschlichen Kommunikation eingebettet und durch diese beeinflusst. Das Analysekonzept lässt sich empirisch anwenden, indem spezifische (thematische) Ausschnitte der zwischenmenschlichen Kommunikation fokussiert und ganzheitlich unter Rückgriff auf vier Analyselinsen analysiert werden. Diese Analyselinsen umfassen 1) die kommunikativen Beziehungen, innerhalb derer die zwischenmenschliche Kommunikation stattfindet, 2) die Kommunikationsmuster, durch die die Kommunikation geprägt ist, 3) die Medien- und Kommunikationsrepertoires, auf die zur Kommunikation zurückgegriffen wird sowie 4) die Funktionen, welche die Kommunikation erfüllt. Im Artikel wird das Konzept der Alltagskommunikation zunächst expliziert, bevor dessen empirische Umsetzbarkeit anhand einer Fallstudie zur Kommunikation über satirische Medieninhalte illustriert wird. In this contribution, the concept of Alltagskommunikation (everyday communication) is introduced, which aims to analyze the complex interpersonal communication entanglements in the digital society in a contextualized way. The concept locates the mobile and sometimes parallel communication processes with other individuals, which are shaped by different media, within the lifeworld of an individual. These processes are understood as interrelated, embedded in and influenced by permanent structures of interpersonal communication. To empirically apply the concept, specific (thematic) segments of interpersonal communication are examined and analyzed holistically through four analytical lenses. These analytical lenses comprise 1) the communicative relationships, in which the interpersonal communication takes place, 2) the patterns of communication by which communication is shaped, 3) the media and communication repertoires utilized for communication, and 4) the functions the communication fulfills. In this article, first, the concept of everyday communication is explicated and, second, its empirical feasibility is illustrated in a case study on interpersonal communication about satirical media content., In this contribution, the concept of Alltagskommunikation (everyday communication) is introduced, which aims to analyze the complex interpersonal communication entanglements in the digital society in a contex-tualized way. The concept locates the mobile and sometimes parallel communication processes with other individuals, which are shaped by different media, within the lifeworld of an individual. These processes are understood as interrelated, embedded in and influenced by permanent structures of interpersonal commu-nication. To empirically apply the concept, specific (thematic) segments of interpersonal communication are examined and analyzed holistically through four analytical lenses. These analytical lenses comprise 1) the communicative relationships, in which the interpersonal communication takes place, 2) the patterns of communication by which communication is shaped, 3) the media and communication repertoires utilized for communication, and 4) the functions the communication fulfills. In this article, first, the concept of everyday communication is explicated and, second, its empirical feasibility is illustrated in a case study on interperso-nal communication about satirical media content.

Digital systems have increasingly become integrated into the modern operating room in the last few decades. This has brought about a massive change, especially in minimally invasive surgery.The article provides an overview of the current technical innovations and the perspectives of digitalization and artificial intelligence (AI) in surgery.The article is based on a literature search via PubMed and research work by the participating coauthors.Current research is increasingly looking at machine learning techniques that take advantage of the complex data in surgery; however, the integration of artificial intelligence systems into the operating room and clinical practice has only just begun.Translational research of artificial intelligence in surgery is still in its infancy but has great potential to improve patient care; however, to accelerate the incorporation of intelligent systems into the clinical practice, the creation of interdisciplinary research groups led by surgeons is necessary.HINTERGRUND: Digitale Systeme haben in den letzten Jahrzehnten zunehmend Einzug in den modernen Operationssaal gehalten. Dadurch hat sich ein massiver Wandel, insbesondere in der minimal-invasiven Chirurgie, vollzogen.Der Artikel soll einen Überblick geben zu den aktuellen technischen Innovationen und den Perspektiven von Digitalisierung und künstlicher Intelligenz (KI) in der Chirurgie.Der Artikel basiert auf einer Literaturrecherche über PubMed und Forschungsarbeiten der beteiligten Koautoren.Aktuelle Forschungsarbeiten befassen sich zunehmend mit maschinellen Lernverfahren, die sich die komplexen Daten in der Chirurgie zunutze machen. Die Einbindung von Systemen künstlicher Intelligenz in Operationssaal und Klinik hat jedoch erst begonnen.Die translationale Erforschung künstlicher Intelligenz in der Chirurgie steht noch am Anfang, bietet aber ein großes Potenzial, die Behandlung der Patienten zu verbessern. Um die Einbindung intelligenter Systeme in die Klinik zu beschleunigen, ist die Schaffung interdisziplinärer Forschungsgruppen unter chirurgischer Leitung nötig.

Die COVID-19-Pandemie stellt derzeit weltweit eine Herausforderung dar. In Österreich konnte eine Krise innerhalb des medizinischen Versorgungssystems bisher verhindert werden. Die Behandlung von Patienten mit ambulant erworbener Pneumonie („community acquired pneumonia“, CAP), inklusive durch SARS-CoV-2-Infektionen, sollte sich auch während der Pandemie weiterhin an evidenzbasierten CAP-Leitlinien orientieren. COVID-19-spezifische Anpassungen sind jedoch sinnvoll. Die Behandlung von Patienten mit chronischen Lungenerkrankungen muss während der Pandemie angepasst werden, ist aber weiterhin zu gewährleisten.

Zusammenfassung Hintergrund Der Wunsch, bis zum Lebensende über sich zu verfügen, hat in unserer Gesellschaft einen hohen Stellenwert erreicht. Frauen und Männer unterschiedlichen Alters, sozio- und bildungsbiografischen Hintergrunds und verschiedener kultureller Prägungen entscheiden zunehmend über künftige Behandlungen im Voraus (Behandlung im Voraus planen, BVP). Ziel der Arbeit Identifikation und Analyse von Forschungsliteratur über das Vorsorgeverhalten von Männern und Frauen in Deutschland. Im Fokus stehen geschlechterspezifische Unterschiede. Material und Methoden Systematischer Review von empirischen Studien mit geschlechterspezifischen Daten zum Vorsorgeverhalten in Deutschland. Dezidierte Analyse von 21 der 479 extrahierten Artikel. Ergebnisse Bei antizipativen Behandlungsentscheidungen zeigt sich, dass das Vorsorgeverhalten von interagierenden Faktoren wie Geschlecht, Alter, kultureller und ethnischer Hintergrund, Religion und Bildung geprägt wird. Eine rein geschlechtsspezifisch erklärbare Prävalenz von Vorsorgeverhalten lässt sich aus den Studien nicht ableiten. Dieses prima facie negative Ergebnis ist z.T. auf das Design der Studien selbst zurückzuführen. Heterogene Daten und wenig ausgeprägte Geschlechtersensibilität lassen die Frage nach dem Verhältnis von Vorsorgeverhalten, Geschlecht und Gender i.d.R. unbeantwortet. Diskussion Die analysierten Studien reduzieren die Dimension Geschlecht auf eine dualistische Klassifikation, blenden individuelle Rollenbilder und Haltungen (Gender) aus und lassen ebenso geographisch-kulturelle Kontexte unberücksichtigt. Hieraus ergibt sich ein Forschungsdesiderat für Studien mit einem reflektierten gender- und kultursensiblen Fokus.

This article reports the case of a 43-year-old woman who presented to the emergency room with headache and paresthesia after a fall on the head while skiing. She had clinical signs of volume depletion and blood test showed severe hyponatremia. Cerebral imaging was unremarkable. The diagnosis of cerebral salt-wasting syndrome (CSWS) was made, which is defined by the presence of extracellular volume depletion due to a tubular defect in renal sodium transport in patients with normal adrenal and thyroid function. The disease is mostly secondary to a neurological disease or head trauma. The patient rapidly improved after volume therapy and treatment with mineralocorticoids. The differentiation of CSWS from the syndrome of inappropriate antidiuretic hormone (SIADH) secretion can be challenging but the distinction is important because treatment options are very different.Wir berichten über eine 43-jährige Frau, die sich mit Kopfschmerzen und Parästhesien nach einem Sturz auf den Kopf beim Skifahren in der Notaufnahme vorstellte. Sie hatte klinische Zeichen eines Volumenmangels und eine schwere Hyponatriämie. Die zerebrale Bildgebung war unauffällig. Es wurde die Diagnose eines zerebralen Salzverlustsyndroms („salt wasting syndrome“ [CSW]) gestellt. Das CSW wird als extrazellulärer Volumenmangel aufgrund eines tubulären Defekts im Natriumtransport bei Patienten mit normaler Nebennieren- und Schilddrüsenfunktion definiert. Die Erkrankung entsteht meist sekundär zu neurologischen Erkrankungen oder Kopfverletzungen. Der Zustand unserer Patientin verbesserte sich schnell nach Volumengabe und der Therapie mit Mineralokortikoiden. Die Unterscheidung zwischen CSW und dem Syndrom der inadäquaten Sekretion von antidiuretischem Hormon (SIADH) kann eine Herausforderung darstellen, ist aber wichtig, da sich die Behandlung grundlegend unterscheidet.

The treatment of choice for soft tissue sarcomas with local involvement is still the complete surgical removal into healthy tissue. The aim of surgery is to achieve tumor-free resection margins in the sense of a R0 resection. No other treatment option can equally replace this important oncological condition. The enormous development in the field of reconstructive plastic surgery and in particular the advances in flap techniques and microsurgery enable limb salvage and the functional reconstruction even in the case of extensive tumors.

The development and homeostasis of multicellular organisms depends on a complex cellular interaction between proliferation, migration, differentiation, adhesion, and cell death. Wnt signaling pathways coordinate these different cellular responses. Wnt signaling plays a role as a regulatory pathway in the osteogenic differentiation of mesenchymal stem cells. The Wnt signaling pathway is an attractive therapeutic target with the potential to directly modulate stem cells responsible for the regeneration of skeletal tissue. Recent studies indicate that Wnt ligands are capable of promoting bone growth, suggesting that Wnt factors could be used to stimulate bone healing in osteogenic disorders.Die Entwicklung und Homöostase von multizellulären Organismen hängt von einem komplexen zellulären Zusammenspiel zwischen Proliferation, Migration, Differenzierung, Adhäsion und Zelltod ab. Die Wnt-Signalwege spielen für die Koordination dieser verschiedenen zellulären Antworten eine wichtige Rolle, insbesondere als regulatorischer Weg bei der osteogenen Differenzierung von mesenchymalen Stammzellen. Der Wnt-Signalweg ist ein attraktives therapeutisches Ziel mit dem Potenzial, Stammzellen, die für die Regeneration des Skelettgewebes verantwortlich sind, direkt zu modulieren. Neuere Untersuchungen zeigen, dass Wnt-Liganden in der Lage sind, das Knochenwachstum zu fördern, was nahe legt, dass Wnt-Faktoren zur Stimulation der Knochenheilung bei osteogenen Störungen verwendet werden könnten.

Performing rebiopsies for primary lung cancer and/or their metastases is becoming more and more prominent in daily practice, as the therapeutical spectrum increases and some newer strategies are dependent on immunohistochemical and/or molecular factors. In general, nearly all recurrent lesions or metastases can be reached. However, frequently invasive procedures are necessary with the need to carefully weigh risks and benefits of rebiopsies for the patient in each case. In this review indications for recurrent and progressive disease as well as risks are discussed and alternatives to rebiopsies are shown. This work is the joint opinion from both the endoscopic and thoracic oncology sections of the German Society of Pneumology (DGP).Rebiopsien bei primären Lungenkarzinomen sowie deren Metastasen werden im klinischen Alltag immer wichtiger, da sich die Therapien weiterentwickeln und häufig gezielte weitere Behandlungsstrategien erst nach immunhistochemischen oder/und molekularen Veränderungen zugelassen sind. Prinzipiell können fast alle Rezidive bzw. progrediente Tumore biopsiert werden, allerdings häufig nur mittels invasiver Maßnahmen. Hier muss der Aufwand und das Risiko des Patienten mit dem zu erwartenden Benefit durch die Rebiopsie in jedem einzelnen Fall überlegt und vorher mit dem Patienten besprochen werden. In der Übersichtsarbeit werden die Indikationen bei Rezidiv und progredienter Erkrankung sowie die Risiken diskutiert und Alternativen zur Rebiopsie aufgezeigt. Diese Arbeit stellt die Empfehlungen der Sektionen 2 (Endoskopie) und 11 (pneumologische Onkologie) der Deutschen Gesellschaft für Pneumologie (DGP) dar.

Biomedical Engineering / Biomedizinische Technik, 43 (s1), ISSN:0013-5585, ISSN:1862-278X

Modern operating room (OR) suites are mostly digitally connected but until now the primary focus was on the presentation, transfer and distribution of images. Device information and processes within the operating theaters are barely considered. Cognitive assistance systems have triggered a fundamental rethinking in the automotive industry as well as in logistics. In principle, tasks in the OR, some of which are highly repetitive, also have great potential to be supported by automated cognitive assistance via a self-thinking system. This includes the coordination of the entire workflow in the perioperative process in both the operating theater and the whole hospital. With corresponding data from hospital information systems, medical devices and appropriate models of the surgical process, intelligent systems could optimize the workflow in the operating theater in the near future and support the surgeon. Preliminary results on the use of device information and automatically controlled OR suites are already available. Such systems include, for example the guidance of laparoscopic camera systems. Nevertheless, cognitive assistance systems that make use of knowledge about patients, processes and other pieces of information to improve surgical treatment are not yet available in the clinical routine but are urgently needed in order to automatically assist the surgeon in situation-related activities and thus substantially improve patient care.

The oncological equivalence of laparoscopic and open rectal cancer resection was evaluated in four multicenter randomized controlled trials. The COLOR II and the COREAN trials demonstrated oncological equivalence; however, the ACOSOG and the ALaCaRT studies came to a different conclusion. In the latter two studies a composite endpoint that assessed the quality of the mesorectal specimen, the completeness of tumor-free circumferential and distal resection margins was chosen. In both trials a higher success rate for open surgery was shown; nevertheless, the validity of this composite endpoint has not been proven and no conclusions on solid oncological endpoints can be drawn. The COLOR II and the COREAN trial therefore remain the only available studies which investigated solid oncological endpoints, such as local recurrence and disease-free survival over an adequate follow-up time period of 3 years; however, the comparability of the study groups at least of the COLOR II trial needs to be called into question as only the experience of the laparoscopic surgeons was assessed. With a local recurrence rate of 5 % in both groups the oncological quality seems nevertheless to be good; therefore, a systematically inadequate control group should not be assumed. At this point it can be concluded that a good oncological outcome can be achieved with laparoscopic rectal resection in the hands of experts. For a final assessment the long-term results of the on-going trials needs to be awaited. If the promising results for laparoscopic surgery of the COLOR II trial are confirmed laparoscopic rectal resection should be preferred to open resection in the future. This conclusion is based on the generally known perioperative benefits of minimally invasive surgery.

The German hospital reimbursement system (G-DRG) is incomplete for endoscopic interventions and fails to differentiate between complex and simple procedures. This is caused by outdated methods of personnel-cost allocation.To establish an up-to-date service catalogue 50 hospitals made their anonymized expense-budget data available to the German-Society-of-Gastroenterology (DGVS). 2.499.900 patient-datasets (2011-2013) were used to classify operation-and-procedure codes (OPS) into procedure-tiers (e.g. colonoscopy with biopsy/colonoscopy with stent-insertion). An expert panel ranked these tiers according to complexity and assigned estimates of physician time. From June to November 2014 exact time tracking data for a total 38.288 individual procedures were collected in 119 hospitals to validate this service catalogue.In this three-step process a catalogue of 97 procedure-tiers was established that covers 99% of endoscopic interventions performed in German hospitals and assigned validated mean personnel-costs using gastroscopy as standard. Previously, diagnostic colonoscopy had a relative personnel-cost value of 1.13 (compared to gastroscopy 1.0) and rose to 2.16, whereas diagnostic ERCP increased from 1.7 to 3.62, more appropriately reflecting complexity. Complex procedures previously not catalogued were now included (e.g. gastric endoscopic submucosal dissection: 16.74).This novel service catalogue for GI-endoscopy almost completely covers all endoscopic procedures performed in German hospitals and assigns relative personnel-cost values based on actual physician time logs. It is to be included in the national coding recommendation and should replace all prior inventories for cost distribution. The catalogue will contribute to a more objective cost allocation and hospital reimbursement - at least until time tracking for endoscopy becomes mandatory.

The German health interview and examination survey for adults (DEGS1) with the mental health module (DEGS1-MH) is the successor to the last survey of mental disorders in the general German population 15 years ago (GHS-MHS). This paper reports the basic findings on the 12-month prevalence of mental disorders, associated disabilities and self-reported healthcare utilization.A representative national cohort (age range 18-79 years, n = 5,317) was selected and individuals were personally examined (87.5 % face to face and 12.5 % via telephone) by a comprehensive clinical interview using the composite international diagnostic interview (CIDI) questionnaire.The overall 12-month prevalence of mental disorders was 27.7 % with substantial differences between subgroups (e.g. sex, age, socioeconomic status). Mental disorders were found to be particularly impairing (elevated number of disability days). Less than 50 % of those affected reported to be in contact with health services due to mental health problems within the last 12 months (range 10-40 % depending on the number of diagnoses).Mental disorders were found to be commonplace with a prevalence level comparable to that found in the 1998 predecessor study but several further adjustments will have to be made for a sound methodological comparison between the studies. Apart from individual distress, elevated self-reported disability indicated a high societal disease burden of mental disorders (also in comparison with many somatic diseases). Despite a relatively comprehensive and well developed mental healthcare system in Germany there are still optimisation needs for treatment rates.

University teaching in ophthalmology has tended to focus on imparting knowledge rather than practical skills. The new skills laboratory at the University Medical Center in Göttingen enables practical skills to be taught. The focus is on basic skills that could help all physicians. The learning goals set are techniques considered basic in ophthalmology that can be mastered without requiring any physician to operate major equipment.The design and results from four semesters of an ophthalmological objective structured clinical examination (OSCE) following students engaged in peer-teaching, as well as feedback from a student questionnaire are described.Practical skills can successfully be taught and mastered within 1 week and 68-100 % of all students achieved the maximum scores in the individual tests. The OSCE and peer- eaching were well received by the students.Practical skills and peer teaching fulfill student educational goals in ophthalmology and are well accepted by undergraduates.

Autologous bone transplants are still the gold standard for defect filling materials and no other material has such a high biological potential. Proven surgical techniques for harvesting cancellous and cortical autografts in the pelvis, the problems and complications are described. The second part of the paper explains the safe handling of osteotomy of the superior anterior iliac spine for pelvic osteotomy and tumor surgery.

Antilipidemics are widely applied to reduce the risk of cardio- and cerebrovascular events. The purpose of this case report is to illustrate the clinical and radiological findings of focal myositis as a side effect of statins and fibrates in 2 patients with forearm involvement. These 2 cases demonstrate that a targeted medical history taking and use of MRI to support the suspected diagnosis, can efficiently facilitate the route to an appropriate therapy.

Flexible bronchoscopy is a standard examination today and is conducted not only in nearly every hospital but also in privately owned practices. The vast majority of patients want sedation for this examination. Such a procedure is nearly always necessary in complex and interventional procedures, irrespective of the patient's wish. The recommendation at hand to use sedation measures for flexible bronchoscopy is based on the results of numerous clinical studies and also takes account of individual experiences in this area. The structural and procedural requirements and the requirements for staff training are defined and should describe the minimum standard when it comes to conducting a bronchoscopy under sedation. Furthermore the drugs recommended for sedation are discussed and their methods of application shown. Finally the recommendations also include suggestions for patient clarification, monitoring and discharge. They should provide the examiner with concrete operating options and therefore above all increase patient safety.

Bronchoscopic training courses are an essential part of the education in bronchoscopy for all kinds of specialisations and professions performing such investigations. All aspects of the application should be mentioned during a course. These recommendations are necessary because the number of bronchoscopies performed in the last years has increased due to the increasing number of patients, improved equipment and better availability. Courses should provide the basic knowledge including main points of indications, preconditions for the procedure and decisions of consequence after bronchoscopy. Participants should be trained in the skills of correct handling and performing flexible bronchoscopies in training dummies. Necessary competence requirements on the course instructor are adequate professional qualifications, paedagogic skills and the availability of appropriate teaching material. Quality assurance of the course should be achieved by consequent evaluation. A widely spread field of bronchoscopic applications can improve patient care in many medical specialisations.

Levobupivacaine and ropivacaine are both used for continuous femoral analgesia after anterior cruciate ligament reconstruction; however it is unknown whether both drugs are equally effective regarding pain control, preservation of mobility and patient satisfaction.In this randomized, placebo-controlled trial 84 patients undergoing anterior cruciate ligament (ACL) reconstruction with quadruple hamstring tendons were studied. For postoperative pain therapy levobupivacaine 0.125%, ropivacaine 0.2% or placebo control with NaCl 0.9% at a rate of 6 ml/h were used for 48 h using a femoral nerve catheter. All patients also received an i.v. patient-controlled analgesia (IVPCA) pump with piritramide.Patient satisfaction was significantly higher and night rest was better in both treatment groups compared to the placebo group but there appeared to be no major differences between the two local anesthetics. Opioid consumption was significantly higher in the placebo group compared to the levobupivacaine group but not the ropivacaine group. The pain scores showed a trend towards higher scores in the placebo group throughout but the difference only reached statistical significance on postoperative day 1. No statistical significant differences in motor block were found between the three groups.Postoperative analgesia for ACL reconstruction during the first 48 h using femoral block with a continuous infusion of levobupivacaine 0.125% or ropivacaine 0.2% in combination with an IVPCA is similarly effective and better than a placebo. Both studied drugs seem to be equally appropriate for this purpose.

It was the aim of this study to compare the sensitivity and specificity of low-dose CT colonography (CTC) with that of optical colonoscopy (OC) in asymptomatic patients undergoing these tests in a screening program for colonic cancer.58 patients (mean age 62.6 years) were included. They underwent low dose CTC and, immediately afterwards, colonoscopy. The colonoscopists were unaware of the CTC findings. A "second look" was performed if a lesion seen in CTC had been missed in the first colonoscopy.A total of 150 lesions were detected and histologically confirmed. 136 were found to be polypoid lesions, classified as either hyperplastic polyps (n = 66) or polyps with intraepithelial neoplasia (n = 70). In the per-patient analysis only 22.4 % of patients had no polypoid lesion, 27.6 % had at least one hyperplastic and 50.0 % had at least one adenomatous lesion. Sensitivity for adenomas of all size categories was calculated 55.7 % for CTC and 92.9 % for OC. This marked difference (both for the detection of individual lesions and the per-patient analyses) does not reach significance in the two-sided McNemar test.There was a high prevalence of lesions with intraepithelial neoplasia in this screening group. OC had a higher sensitivity than CTC in the detection of lesions smaller than 10 mm.

Locked plating is one of the most modern plating techniques, the aim of which is to achieve the smallest possible surgical trauma, small incisions, preserve blood supply to the bone and adjacent soft tissues, and to ensure a minimal bone-implant interface.

With the increasing use of minimally invasive plate osteosynthesis in the last years almost every anatomical region was included in this new technique. Thus, it is not used any more for certain fractures and problematic areas, but also in fractures where it represents a challenge to established osteosynthesis techniques like intramedullary nailing or conventional plating. Therefore the challenge for the treating surgeon increased to find the right answer for the particularities of an individual fracture by choosing the optimal method. The most popular indications for the use of minimally invasive plate osteosynthesis are presented and the technical details are discussed. The possibilities for complications--in a common way and for specific fractures--are presented and discussed.

Minimally invasive techniques and developments of implants with angular stability have led to a renaissance of plate osteosynthesis for fracture stabilization in recent years. They represent a major source of success which has facilitated minimally invasive plate osteosynthesis (MIPO) or even made it feasible. For implants with LCP technology all current types of screws can be used and/or combined. However, the treating surgeon is still confronted with the decision which fixation mode, absolute or relative stability, is required for each individual fracture. Moreover, reduction techniques, intra-operative imaging and the biomechanical features of the selected implant require a more meticulous preoperative planning. Minimizing the surgical trauma has resulted in decreased complication rates of problematic fractures. However, the particular inherent risks of a closed procedure have to be evaluated for each body region to avoid severe complications.

Dual-source-CT-technology (DSCT) improves temporal resolution of cardiac computed tomography to 83 ms per heart-phase. In this study, the clinical performance of this new method is evaluated.In fifty patients (33 male, 17 female; age 50 +/- 13 years) with suspected coronary heart disease, CT angiography (slice thickness 0.75 mm, contrast-agent 60-80 ml iomeprol) was performed with a Somatom Definition scanner. Based on the coronary 15-segment-model of the AHA, scores for image quality and lumen reduction were established to enable the observer, to give recommendations for further therapy.Out of 750 possible AHA-segments, 655 were depicted (87.3%). 591 segments (90.2%) were assessed without any limitation of quality, 49 (7.5%) segments showed moderate, and 15 (2.3%) segments severe limitation in image quality. 508 (77.6%) segments were without pathological findings, 92 (14.0%) segments had minimal atherosclerotic lesions, 42 (6.4%) segments suffered from stenoses with lumen reduction less than 70%, and 13 (2.0%) showed significant stenoses of more than 70%. In 31 patients (62%), coronary heart disease was ruled out by CT angiography without any need for further non-invasive or invasive diagnostics. 8 patients (16%) underwent stress-testing for ischemia. In 11 (22%) patients coronary angiography was recommended, and DSCT findings were confirmed in 10 cases. Only one LCx stenosis was overestimated in DSCT.Contrast-enhanced DSCT is a powerful tool in diagnosis of coronary heart disease. 98% of coronary segments could be assessed in diagnostic quality, and at least 90% of haemodynamically significant coronary stenoses were detected.

In the present study, a semi-automatic segmentation and classification algorithm is proposed for the analysis of histological and cytological images. In view of the fact that histological and cytological images usually exhibit poor contrast and blurred outlines, classical segmentation algorithms often fail to detect relevant structures. A new algorithm for texture segmentation based on signal processing methods in combination with machine learning techniques was therefore developed.

The CERAD-NP battery represents well-established tests for the neuropsychological diagnosis of characteristic cognitive deficits in Alzheimer's dementia. However, the use of neuropsychological tests requires reliable standard values for the population under consideration, taking sociodemographic characteristics like age, education and gender into account. This report presents age-, education- and gender-specific reference values for the subtests verbal fluency, word list memory, word list recall and word list recognition as well as the word list savings score of the CERAD-NP battery. The study sample consists of 2891 general practitioners' patients from Germany aged 75 years and older. The study participants had a mean age of 80.2 years (SD=3.6); thus, this report provides reliable reference values for the neuropsychological diagnosis of dementia in older age groups.

As an alternative to surgery, endovascular therapy with stent grafts has become the second main treatment option for infrarenal abdominal aortic aneurysms. Unlike surgery, endovascular treatment with stent grafts is also applicable in patients unfit for open repair. Despite current improvements in endovascular repair devices, significant anatomic barriers still exclude this technique for a large number of patients. Computed tomography, magnetic resonance imaging, and ultrasound are essential for diagnostics, preintervention planning, and postintervention follow-up of abdominal aneurysms treated with stent grafts. This review covers etiology, pathology, and diagnostic aspects. Materials and methods for endovascular treatment of abdominal aortic aneurysms are presented in detail, and clinical results and complications are discussed.