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Introduction The placement of intramammary marker clips has proven to be helpful for tumor localization in patients undergoing neoadjuvant chemotherapy and breast-conserving surgery. The purpose of our study was to investigate the feasibility of using a clip marker system for breast cancer localization and its influence on the imaging assessment of treatment responses after neoadjuvant chemotherapy. Patients and Methods Between March and June 2015, a total of 25 patients (n = 25), with a suspicion of invasive breast cancer with diameters of at least 2 cm (cT2), underwent preoperative sonographically guided core needle biopsy using a single-use breast biopsy system (HistoCore™) and intramammary clip marking using a directly adapted clip system based on the established O-Twist Marker™, before their scheduled preoperative neoadjuvant chemotherapy. Localization of the intramammary marker clip was controlled by sonography and digital breast tomosynthesis. Results Sonography detected no dislocation of intrammammary marker clips in 20 of 25 patients (80 %), while digital breast tomosynthesis showed accurate placement without dislocation in 24 patients (96 %) (p Conclusion Our study underscores the importance of intramammary marking clip systems before neoadjuvant chemotherapy. Placement of marker clips is advised to facilitate accurate tumor bed localization. With regard to digital breast tomosynthesis, its development continues to improve the quality of diagnostics and the therapy of breast cancer particularly for small breast cancer tumors or in neoadjuvant chemotherapy setting.

Objective Three-dimensional (3D) printing has become widely available, and a few cases of its use in clinical practice have been described. The aim of this study was to explore facilities for the semi-automated delineation of breast cancer tumors and to assess the feasibility of 3D printing of breast cancer tumors. Methods In a case series of five patients, different 3D imaging methods—magnetic resonance imaging (MRI), digital breast tomosynthesis (DBT), and 3D ultrasound—were used to capture 3D data for breast cancer tumors. The volumes of the breast tumors were calculated to assess the comparability of the breast tumor models, and the MRI information was used to render models on a commercially available 3D printer to materialize the tumors. Results The tumor volumes calculated from the different 3D methods appeared to be comparable. Tumor models with volumes between 325 mm3 and 7,770 mm3 were printed and compared with the models rendered from MRI. The materialization of the tumors reflected the computer models of them. Conclusion 3D printing (rapid prototyping) appears to be feasible. Scenarios for the clinical use of the technology might include presenting the model to the surgeon to provide a better understanding of the tumor's spatial characteristics in the breast, in order to improve decision-making in relation to neoadjuvant chemotherapy or surgical approaches. J. Surg. Oncol. 2017;115:238–242. © 2016 Wiley Periodicals, Inc.

Although mammography screening programs do not include ultrasound examinations, some diagnostic units do provide women with both mammography and ultrasonography. This article is concerned with estimating the risk of a breast cancer patient diagnosed in a hospital-based mammography unit having a tumor that is visible on ultrasound but not on mammography. A total of 1,399 women with invasive breast cancer from a hospital-based diagnostic mammography unit were included in this retrospective study. For inclusion, mammograms from the time of the primary diagnosis had to be available for computer-assisted assessment of percentage mammographic density (PMD), as well as Breast Imaging Reporting and Data System (BIRADS) assessment of mammography. In addition, ultrasound findings were available for the complete cohort as part of routine diagnostic procedures, regardless of any patient or imaging characteristics. Logistic regression analyses were conducted to identify predictors of mammography failure, defined as BIRADS assessment 1 or 2. The probability that the visibility of a tumor might be masked at diagnosis was estimated using a regression model with the identified predictors. Tumors were only visible on ultrasound in 107 cases (7.6%). PMD was the strongest predictor for mammography failure, but age, body mass index and previous breast surgery also influenced the risk, independently of the PMD. Risk probabilities ranged from 1% for a defined low-risk group up to 40% for a high-risk group. These findings might help identify women who should be offered ultrasound examinations in addition to mammography.

Introduction: This study aimed to compare the accuracy of sonography versus digital breast tomosynthesis to locate intramammary marker clips placed under ultrasound guidance. Patients and Methods: Fifty patients with suspicion of breast cancer (lesion diameter less than 2 cm [cT1]) had ultrasound-guided core needle biopsy with placement of a marker clip in the center of the tumor. Intramammary marker clips were subsequently located with both sonography and digital breast tomosynthesis. Results: Sonography detected no dislocation of intrammammary marker clips in 42 of 50 patients (84 %); dislocation was reported in 8 patients (16 %) with a maximum dislocation of 7 mm along the x-, y- or z-axis. Digital breast tomosynthesis showed accurate placement without dislocation of the intramammary marker clip in 48 patients (96 %); 2 patients (4 %) had a maximum clip dislocation of 3 mm along the x-, y- or z-axis (p

Aim: This prospective clinical study aimed to evaluate whether it would be possible to reduce the rate of re-excisions using CMOS technology, a specimen radiography system (SRS) or digital breast tomosynthesis (DBT) compared to a conventional full field digital mammography (FFDM) system. Material and Method: Between 12/2012 and 2/2013 50 patients were diagnosed with invasive breast cancer (BI-RADS™ 5). After histological verification, all patients underwent breast-conserving therapy with intraoperative imaging using 4 different systems and differing magnifications: 1. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 lp/mm; 2. BioVision™ (Bioptics, Tucson, AZ, USA), CMOS technology, photodiode array, flat panel, tungsten source, focus 0.05, resolution 50 µm pixel pitch, 12 lp/mm; 3. the Trident™ specimen radiography system (SRS) (Hologic, Bedford, MA, USA), amorphous selenium, tungsten source, focus 0.05, resolution 70 µm pixel pitch, 7.1 lp/mm; 4. tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 µm pixel pitch, 8 lp/mm, angular range 50 degrees, 25 projections, scan time > 20 s, geometry: uniform scanning, reconstruction: filtered back projection. The 600 radiographs were prospectively shown to 3 radiologists. Results: Of the 50 patients with histologically proven breast cancer (BI-RADS™ 6), 39 patients required no further surgical therapy (re-excision) after breast-conserving surgery. A retrospective analysis (n = 11) showed a significant (p

PURPOSE: We report on our experience with ambulatory Home Care Telemedicine in chronic heart failure and unclear arrhythmias and its cost effectiveness if used additionally to standard care. MATERIALS AND METHODS: In this study a 12 month follow up of Home Care Telemedicine in cardiology was performed in 95 patients in Thuringia. (25 female, 65±16 and 70 male, 67±9 years). Patients got a mobile 12-channel ECG, 5 with suspected paroxsysmale tachycardia, 90 with chronic heart failure (70 NYHA I und II, 20 NYHA III), NYHA III patients additionally transmitted vital parameters weight, blood pressure and pulse on a daily base. In case of acute problems the ambulatory ECG was transferred and a physician in the telemedicine centre could be reached 24 h a day. The rate of rehospitalization was compared to a matched control group. RESULTS: 283 emergency calls were registered, 42% outside work hours (workdays 8.00-18.00). In 74% cases an advice was given, in 20% a referral to the general practitioner was recommended on the next day, only 6% were referred the hospital or an ambulance was called. The rate, duration and costs of rehospitalizations were significantly lower in the telemedicine group. DISCUSSION: Shortening of resources in stationary care capacity in an increasingly older population requires new approaches for ambulatory disease management particularly for chronic affected patients. Such an opportunity for monitoring chronic heart failures additionally to hospital care, general practitioners and cardiologist is given by Home Care Telemedicine. CONCLUSION: Home Care Telemedicine offers a new possibility to improve ambulatory care of patients with chronic cardiac diseases and to support the health systems, especially the patients themselves and the physicians caring for them.

Enterococci are important inhabitants of the animal intestine and are widely used in probiotic products. A probiotic strain is expected to possess several desirable properties in order to exert beneficial effects. Therefore, the objective of this study was to isolate, characterize and identify Enterococcus sp. from chicken cecal and fecal samples to determine potential probiotic properties. Enterococci were isolated from chicken ceca and feces of thirty three clinically healthy chickens from a local farm. In vitro studies were performed to assess antibacterial activity of the isolated LAB (using agar well diffusion and cell free supernatant broth technique against Salmonella enterica serotype Enteritidis), survival in acidic conditions, resistance to bile salts, and their survival during simulated gastric juice conditions at pH 2.5. Isolates were identified by biochemical carbohydrate fermentation patterns using an API 50 CHL kit and API ZYM kits and by sequenced 16S rDNA. An isolate belonging to E. faecium species exhibited inhibitory effect against S. enteritidis. This isolate producing a clear zone as large as 10.30 mm or greater and was able to grow in the coculture medium and at the same time, inhibited the growth S. enteritidis. In addition, E. faecium exhibited significant resistance under highly acidic conditions at pH 2.5 for 8 h and survived well in bile salt at 0.2% for 24 h and showing ability to survive in the presence of simulated gastric juice at pH 2.5. Based on these results, E. faecium isolate fulfills some of the criteria to be considered as a probiotic strain and therefore, could be used as a feed additive with good potential for controlling S. Enteritidis in chickens. However, in vivo studies are needed to determine the safety of the strain., {"references":["H. A. Abdel-Rahman., S. M. Shawky, H. Ouda, A. A. Nafeaa, and S. H.\nOrabi, \"Effect of Two Probiotics and Bioflavonoids Supplementation to\nthe Broilers Diet and Drinking Water on the Growth Performance and\nHepatic Antioxidant Parameters\". Global Veterinaria 10 (6): 734-741,\n2013.","R. Herich, and M. Levkut, \"Lactic acid bacteria, probiotics and immune\nsystem\". Veterinární medicína, 47, 169-180, 2002.","P. Hlivak, J. Odraska, M. Ferencik, L. Ebringer, E. Jahnova, and A.\nMikes, \"One-year application of probiotic strain Enterococcus faecium\nM-74 decreases serum cholesterol levels\". Bratisl. Lek. Listy 106, 67–\n72, 2005.","Y. Huang, and Y. Zheng, \"The probiotic Lactobacillus acidophilus\nreduces cholesterol absorption through the down-regulation of\nNiemann–Pick C1-like 1 in Caco-2 cells\". Br. J. Nutr. 9, 1–6, 2009.","L. Pascual, F. Ruiz, W. Giordano, and I. L. Barberis, \"Vaginal\ncolonization and activity of the probiotic bacterium Lactobacillus\nfermentum L23 in a murine model of vaginal tract infection\". Journal of\nMedical Microbiology 59, 360–364, 2010.","O. Ashayerizadeh, B. Dastar, M. Shams Shargh, E. Rahmatnejad, and A.\nAshayerizadeh, \"Influence of prebiotic and two herbal additives on\ninterior organs and hematological indices of broilers\". Journal of Animal\nand Veterinary Advances. 8(9), p. 1851-1855, 2009.","A. Bhardwaj, G. Kaur, H. Gupta, S. Vij, and R. K. Malik, \"Interspecies\ndiversity, safety and probiotic potential of bacteriocinogenic Enterococcus faecium isolated from dairy food and human faeces\".\nWorld Journal of Microbiology and Biotechnology, 27, 591-602, 2011.","J. A. Patterson, and K. M. Burkholder, \"Application of prebiotics and\nprobiotics in poultry production. Poultry Sci., 82: 627-631, 2003.","A. Ahmadova, S. D. Todorov, Y. Choiset, H. Rabesona, T. M. Zadi,\nKuliyev, A., B.D.G.M. Franco, J. M. Chobert, and T. Haertlé,\n\"Evaluation of antimicrobial activity, probiotic properties and safety of\nwild strain Enterococcus faecium AQ71 isolated from Azerbaijani Motal\ncheese\". Food Control 30, 631–64, 2013.\n[10] B. B. Matijašic´, T. Obermajer, and I. Rogelj, \"Quantification of\nLactobacillus gasseri, Enterococcus faecium and Bifidobacterium\ninfantis in a probiotic OTC drug by real-time PCR\". Food Control 21,\n419–425, 2010.\n[11] L. Saavedra, M. P. Taranto, F. Sesma, and G. F. de Valdez, \"Homemade\ntraditional cheeses for the isolation of probiotic Enterococcus faecium\nstrains\". Int. J. Food Microbiol. 88, 241–245, 2003.\n[12] J. Benyacoub, P. F. Perez, F. Rochat, K. Y. Saudan, G. Reuteler, N.\nAntille, M. Humen, G. L. De Antoni, C. Cavadini, S. Blum, and E. J.\nSchiffrin, \"Enterococcus faecium SF68 enhances the immune response\nto Giardia intestinalisin mice\". J. Nutr. 135: 1171–1176, 2005.\n[13] D. G. V. Emmanuel, A. Jafari, K. A. Beauchemin, J. A. Leedle, and B.\nN. Ametaj, \"Feeding live cultures of Enterococcus faecium and\nSaccharomyces cerevisiae induces an inflammatory response in feedlot\nsteers\". J. Anim. Sci. 85:233–239, 2007.\n[14] U. Lodemann, K. Hubener, N. Jansen, and H. Martens, \"Effects of\nEnterococcus faecium NCIMB 10415 as probiotic supplement on\nintestinal transport and barrier function of piglets\". Arch. Anim. Nutr.\n60:35–48, 2006.\n[15] L. Scharek, J. Guth, K. Reiter, K. D. Weyrauch, D. Taras, P. Schwerk, P.\nSchierack, M. F. Schmidt, L. H. Wieler, and K. Tedin, \"Influence of a\nprobiotic Enterococcus faecium strain on development of the immune\nsystem of sows and piglets\". Vet. Immunol. Immunopathol. 105:151–\n161, 2005.\n[16] W. Theppangna, K. Otsuki, and T. Murase, \"Inhibitory effects of\nEnterococcus strains obtained from a probiotic product on in vitro\ngrowth of Salmonella enteric serovar Enteritidis strain IFO3313\". J.\nFood Prot. 69: 2258–2262, 2006.\n[17] D. Taras, W. Vahjen, M.Macha, and O. Simon, \"Performance, diarrhea\nincidence, and occurrence of Escherichia coli virulence genes during\nlong-term administration of a probiotic Enterococcus faecium strain to\nsows and piglets\". J. Anim. Sci. 84:608–617, 2006.\n[18] M. Tokumaru, H. Konuma, M. Umesako, S.Konno, and K. Shinagawa,\n\"Rates of detection of Salmonella and Campyobacterin meats in\nresponse to the sample size and the infection level of each species\". Int.\nJ. Food Microbiol. 13:41–46, 1991.\n[19] M. A. Ehrmann, P. Kurzak, J. Bauer, and R. F. Vogel, \"Characterization\nof lactobacilli towards their use as probiotic adjuncts in poultry\". J.\nAppl. Microbiol. 92:966–975, 2002.\n[20] L. M. Shin, R. J. McNally, S. M. Kosslyn, W. L. Thompson, S. L.\nRauch, and N. M. Alpert, \"Regional cerebral blood flow duringscriptdriven\nimagery in childhood sexual abuse-related posttraumatic stress\ndisorder: A positron emission tomographic investigation\". Am J\nPsychiatry 156:575–584, 1999.\n[21] K. Perelmuter, M. Fraga, and P. Zunino, \"In vitro activity of potential\nprobiotic Lactobacillus murinus isolated from the dog\". Journal of\nApplied Microbiology, 104, 1718-1725, 2008.\n[22] Y. Huang, and M. C. Adams, \"In vitro assessment of the upper\ngastrointestinal tolerance of potential probiotic dairy propionibacteria\".\nInternational Journal of Food Microbiology, 91, 253 -260, 2004.\n[23] A. R. Madureira, M. S. Gião, M. E. Pintado, A. M. P. Gomes, C. Freitas,\nand F. X. Malcata, \"Incorporation and survival of probiotic bacteria in\nwhey cheese matrices\". J. Food Sci. 70(3): M161-M165, 2005.\n[24] M. Succi, P. Tremonte, A. Reale, E. Sorrentino, L. Grazia, and S.\nPacifico, \"Bile salt and acid tolerance of Lactobacillus rhamnosus\nstrains isolated from Parmigiano Reggiano cheese\". FEMS\nMicrobiology Letters, 244, 129-137, 2005.\n[25] S. Pieniz, R. Andreazza, T. Anghinoni, F. Camargo, and A. Brandelli,\n\"Probiotic potential, antimicrobial and antioxidant activities of\nEnterococcus durans strain LAB18s. Food Control 37, 251-256, 2014.\n[26] P. Sun, J. Wang, and Y. Jiang, \"Effects of Enterococcus faecium (SF68)\non immune function in mice\". Food Chemistry, 123, 63-68, 2010.\n[27] B. Hyronimus, C. L. Marrec, S. A. Hadj, and A. Deschamps, \"Acid and\nbile tolerance of spore-forming lactic acid bacteria\". International\nJournal of Food Microbiology, 61, 193-197, 2000.\n[28] J. Gong, R., J. Forster, and H. Yu, \"Diversity and phylogenetic analysis\nof bacteria in the mucosa of chicken ceca and comparison with bacteria\nin the cecal lumen\". FEMS Microbiol Lett 208:1–7, 2002.\n[29] J. B. Payne, J. A. Osborne, P. K. Jenkins, and B. W. Sheldon, \"Modeling\nthe growth and death kinetics of Salmonella in poultry litter as a\nfunction of pH and water activity\". Poult. Sci., 86: 191-201, 2007.\n[30] EFSA, The community summary report on trends and sources of\nzoonoses and zoonotic agents in the European Union in 2007. EFSA J\n223:1–320, 2009.\n[31] H. R. Taheri, H. Moravej, F. Tabandeh, M. Zaghari, and M. Shivazad,\n\"Screening of lactic acid bacteria toward their selection as a source of\nchicken probiotic\". Poult. Sci. 88:1586-1593, 2009.\n[32] M. Chichlowski, J. Croom, B. W. McBride, G. Davis, L. Daniel, and M.\nKoci, \"Direct-fed microbial and salinomycin modulate whole body and\nintestinal oxygen consumption and intestinal enterocytes cytokine\nproduction in the broiler chick\". Poult. Sci., 86: 1100-1106, 2007.\n[33] M. A. Riley, and J. E. Wertz, \"Bacteriocins: evolution, ecology, and\napplication\". Annual review of microbiology, Vol.56, pp. 117-137, ISSN\n0066-4227, 2002.\n[34] P. Audisio, A.De Biase, G. Antonini, M. Belfiore, and M. Oliverio,\n\"Morphological, molecular and ecological evidence of a new Euro-\nAnatolian species of the Meligethes coracinus complex (Coleoptera:\nNitidulidae). Insect Systematics and Evolution, Volume 31, Issue\n4, p. 361 – 385, 2000.\n[35] R. Herich, T. Kokinčáková, A. Lauková, and M. Levkutová, \"Effect of\npreventive application of Enterococcus faecium EF55 on intestinal\nmucosa during salmonellosis in Chickens\". Czech J. Anim. Sci., 55, (1):\n42–47, 2010.\n[36] V. Strompfová, and A. Lauková, \"In vitro study on bacteriocin\nproduction of enterococci associated with chickens\". Anaerobe 13: 228-\n237, 2007.\n[37] M. Ashraf, and N. A. Akram, \"Improving salinity tolerance of plants\nthrough conventional breeding and genetic engineering: an analytical\ncomparison\". Biotechnol. Adv., 27: 744-52, 2009."]}

In any detection scheme, including biosensor-based approaches, the pathway from sample to answer involves at least three key steps. These include: use of a statistically valid sampling plan; application of preanalytical sample preparation methods for capture, separation, filtration, and/or concentration of pathogens or cellular analytes from complex food matrices; and use of a suitable detection technique. The quality of an assay’s output is a sum function of each of the component steps. Until recently, most research efforts have been focused solely on detection, but novel methods for sampling and sample preparation are now receiving greater attention. This chapter focuses on the need for sample preparation, the challenges presented by various components of the food matrix, and various options available for sampling and sample manipulation prior to biosensor-based detection.

A 44 year old male patient presented with severe hypertension. The diagnostic work-up revealed elevated levels of plasma renin activity (about 10 times the upper limit of normal) in the presence of normal plasma aldosterone levels and serum potassium concentrations. Renovascular disease was excluded by angiography. Selective renal vein sampling did not show any renin gradient. CT-scans of the abdomen demonstrated normal morphology of the kidneys and adrenals but revealed a big mass in the pancreatic corpus and tail with infiltration of the splenic vein and the presence of enlarged local lymph nodes. The endocrine nature of the pancreatic mass was further supported by a positive octreotide scintigraphy scan. Surgical removal of the tumor by left sided pancreatectomy combined with splenectomy resulted in rapid normalization of elevated renin concentrations as well as blood pressure. Histological examination of the tumor tissue revealed the presence of a neuroendocrine pancreatic carcinoma. Highly (x 70) elevated renin levels were detected by radioimmunoassay in the tumor tissue. To our knowledge this is the first renin-producing neuroendocrine pancreatic carcinoma described in the literature. The present paper describes the case in detail and reviews the available literature on clinical symptomatology, diagnosis and treatment of renin-producing tumors.

We have observed the process of associative ionization (AI) in collisions between hydrogen and rare gas atoms both prepared in their ground states (H + XXH+ + e- with X = Ar,Kr,Xe). This is the first experimental observation of this process, which we compare to the other charge-producing cross sections reported previously. AI takes place only in a small region of collision energies close to threshold. The cross sections show a distinct maximum, with a typical value of about 2×10-19 cm2. In contrast to the heavier rare gases AI is not observed in collisions of atomic hydrogen with He and Ne.

Mammography is the central diagnostic method for clinical diagnostics of breast cancer and the breast cancer screening program. In the clinical routine complementary methods, such as ultrasound, tomosynthesis and optional magnetic resonance imaging (MRI) are already combined for the diagnostic procedure. Future developments will utilize investigative procedures either as a hybrid (combination of several different imaging modalities in one instrument) or as a fusion method (the technical fusion of two or more of these methods) to implement fusion imaging into diagnostic algorithms. For screening there are reasonable hypotheses to aim for studies that individualize the diagnostic process within the screening procedure. Individual breast cancer risk prediction and individualized knowledge about sensitivity and specificity for certain diagnostic methods could be tested. The clinical implementation of these algorithms is not yet in sight.

tool to detect significant renal artery stenosis? Purpose: To evaluate the diagnostic value of multidetector CT angiography (MDCTA) of the renal arteries. Methods: 27 patients underwent MDCTA of the renal arteries. Scan parameters were: collimation 4 × 1 mm, pitch 1.5, effective slice thickness 1.25 mm, reconstruction increment 0.8mm, circulation time measurement, power injection of 80 ml iomeprol 400, flow 4 ml/sec. Independent reading on laser film was done by two radiologists using edited maximum intensity projections, multiplanar reconstructions and source images. Standard of reference was a 3D-FLASH MR angiography (1.5 T, 3.9/1.2, 10° 0.2 mmol GdDTPA/kg bw) in 10 and intraarterial angiography in 17 patients. Results: Analysing 63 arteries, sensitivity, specificity, positive predictive value and negative predictive value in terms of detection of moderate and high grade renal artery stenosis (n = 10) were 90, 98, 90 and 98% for reader A, and 90% each for reader B, respectively (κ = 0.91 interobserver agreement). 1/11 acessory renal arteries was missed by both angiography and MDCTA. Image quality was graded as excellent or good in 26/27 of cases by both readers. Conclusion: MDCTA proved to be a highly accurate tool in the detection of therapeutically relevant renal artery stenosis.

Nipple position provides useful diagnostic informations in reading automated 3D breast ultrasound (ABUS) images. The identification of nipples is required to localize and determine the quadrants of breast lesions. Additionally, the nipple position serves as an effective landmark to register an ABUS image to other imaging modalities, such as digital mammography, breast magnet resonance imaging (MRI), or tomosynthesis. Nevertheless, the presence of speckle noise induced by interference waves and variant imaging directions in ultrasonography poses challenges to the task. In this work, we propose a fast and automated algorithm to detect nipples in 3D breast ultrasound images. The method fully takes advantages of the consistent characteristics of ultrasonographic signals observed at nipples and employs a multi-scale Laplacian-based blob detector to eventually identify nipple positions. The accuracy of the proposed method was tested on 113 ABUS images, resulting in a distance error of 6.6±8.9 mm (mean ±std).

Die Mammographie ist die zentrale diagnostische Methode der klinischen symptombezogenen Abklarung von Brusterkrankungen und des Brustkrebsscreenings. In der klinischen Diagnostik wird sie heute schon oft durch zusatzliche Untersuchungsmethoden wie dem Ultraschall, der Tomosynthese und ggf. auch der MRT-Bildgebung unterstutzt. Zukunftige Entwicklungen gehen in die Richtung, dass diese Kombination aus 2 oder mehr Untersuchungsverfahren entweder in Hybrid- (Aufnahme mehrerer unterschiedlicher Bildmodalitaten in einem einzigen Gerat) oder in Fusionsmethoden (Zusammenfuhrung und Registrierung von Bilddaten aus verschiedenen Modalitaten) technisch professionalisiert werden. Des Weiteren konnten an subgruppenbezogene Erkrankungsrisiken und individuelle Sensitivitaten und Spezifitaten angepasste Diagnostikkombinationen fur eine Screeningdiagnostik Gegenstand kunftiger Studien sein. Wir stellen die aktuellen Entwicklungen auf diesen Gebieten und deren momentane Relevanz fur die klinische Praxis und Entwicklungspotenzial fur die Zukunft dar.

TIM (Zeppelin Chirurgische Instrumente GmbH, 82 049 Pullach, Germany) is a tomographic imaging system which enables surgeons to visualize the pathologic lesions three dimensionally in relationship to the surrounding structures. The distance and the angle between the pathologic lesion and the anatomical and/or bony landmarks as well as the volume of the mass lesion can be measured. Therefore an accurate localization of the lesion is possible with this technique. It is very applicable for planning of surgery on skull base tumors. The surgical procedure for small and well-defined, intrinsic pathologic deep-seated brain lesions, however, becomes much easier by using the stereotactic techniques of this system. The target point and the direction brain-surface-to-lesion can be determined within seconds. Before the aiming probe is inserted to the target, the cortical motor area is mapped by direct electrical stimulation. The approach can be varied depending on the results of these neurophysiologic investigations of the brain surface. The dissection is made along the aiming probe up to the target point. Because of the fixation of the brain with the needle, a brain shifting due to the dissection as well as to CSF release is diminished. Forty patients with deep-seated intracerebral lesions were operated on during a 13 months period by these combined techniques in our service. Using this technique, we never made a negative exploration. In all but three patients, total removal of the mass lesion was achieved. Permanent neurological deficits were observed in two patients only. In our opinion, this combined imaging and neurophysiological technique is easy to perform, and of major benefit for the patients due to its accuracy and is preferable in comparison with other single computer localizer techniques without neurophysiological monitoring.

Introduction: A newly adapted clip system for intramammary marking during ultrasound-guided core needle biopsy for suspicion of breast cancer is described and evaluated here. Material and Method: Fifty patients with suspicion of breast cancer (cT2) had ultrasound-guided core needle biopsy using a newly adapted clip marker system (HistoCore™ and O-Twist Marker™). Subsequently, ultrasound follow-up and tomosynthesis scans were done to determine the location of the marker clips. Results: No dislocation of the marker clip was detected on ultrasound in 45 of 50 patients (90 %), and 5 patients (10 %) had a maximum dislocation of 5 mm along the x-, y- or z-axis. Tomosynthesis scans demonstrated precise placement without dislocation of the clip markers in 48 patients (96 %); 2 patients (4 %) had a maximum dislocation of 3 mm along the x-, y- or z-axis. Conclusion: The newly developed clip marker system, a combination of a single-use breast biopsy needle and a precise, length-adapted intramammary marker clip, represents a further improvement in oncological therapy. This is of particular importance for patients requiring subsequent neoadjuvant chemotherapy, as in cases with complete tumour remission, there is no target point for preoperative, ultrasound-guided wire marking.

Traditionally, populations of microbes have been characterized rather than individual cells. Methods for examining individual cells have long been available but there were technological barriers. The rapidity and ease of growing microbes to large numbers has limited the motivation to study them individually and terminology reinforced the belief that cell populations comprise assemblages of identical cells. Recognition of the heterogeneity of individual cells, coupled with technology capable of resolving discrete differences has driven single-cell microbiology, enabling the high-resolution study and physical manipulation of individual microbes – even allowing detection and tracking of single molecules within living cells. The list of single-cell techniques or their refinements is growing.

STORIA DELL'INSEDIAMENTO, DELL'AMBIENTE E DELLO SFRUTTAMENTO UMANO DI UN BACINO INTERMONTANO NELL'APPENNINO CENTRALE: LA RICOGNIZIONE 1988–91 A RIETI, PARTE II. MODELLI DI SFRUTTAMENTO DEL TERRITORIO ED ELENCO DEI SITIQuesta seconda parte della relazione finale sulla ricognizione a Rieti (cf. Papers of the British School at Rome 60 (1992), 213–89, per Parte I) presenta ulteriori informazioni ed interpretazioni sui modelli di trasformazione degli insediamenti e di uso del territorio nel tempo, insieme al completo elenco dei siti. La discussione sull'insediamento e sull'uso del territorio è basata su una dettagliata analisi della distribuzione spaziale del materiale ceramico di diverse fasi all'interno del transetto interessato dalla ricognizione. Comunque, la maggior parte di questa relazione riguarda l'elenco dei siti, con descrizioni di tutti i siti registrati e liste riassuntive, per ogni singolo sito, della ceramica e dei laterizi raccolti nonchè delle fasi di attività attestate.

Absolute single-particle detection efficiencies of a microchannel plate (MCP) detector were determined by photo-ionization of atoms or molecules. The ionized heavy particles were detected in coincidence with the resulting electrons. This method allows the determination of detection efficiencies without a knowledge of the absolute event rates. We obtained the detection efficiencies for the ions H2+, D2+, HD+, H+, D+ and Ar+ in the impact energy range 0-5 keV. The detection efficiencies saturate above 3 keV and reach generally 41%. This value seems to reflect mainly the physically effective area of the MCP.

We report integral cross sections for the collision processes between H(D) atoms and H2(D2) molecules in the energy range from threshold to 170 eV leading to charged collision products. We observe not only charge exchange and target or projectile ionization such as H+H2 to H-+H2+ and H+H2 to H+e+H2+ but also associative ionization, H+H2 to H3++e, and heavy particle exchange, D+H2 to HD++H-. Typical absolute cross section values are between 10-21 cm2 and 10-17 cm2.

In the process of risk stratification, a logistic calculation of mortality risk in percentage is easier to interpret. Unfortunately, there is no reliable logistic model available for postoperative intensive care patients. The aim of this study was to present the first logistic model for postoperative mortality risk stratification in cardiac surgical intensive care units. This logistic version is based on our previously presented and established additive model (CASUS) that proved a very high reliability.In this prospective study, data from all adult patients admitted to our ICU after cardiac surgery over a period of three years (2007-2009) were collected. The Log-CASUS was developed by weighting the 10 variables of the additive CASUS and adding the number of postoperative day to the model. Risk of mortality is predicted with a logistic regression equation. Statistical performance of the two scores was assessed using calibration (observed/expected mortality ratio), discrimination (area under the receiver operating characteristic curve), and overall correct classification analyses. The outcome measure was ICU mortality.A total of 4054 adult cardiac surgical patients was admitted to the ICU after cardiac surgery during the study period. The ICU mortality rate was 5.8%. The discriminatory power was very high for both additive (0.865-0.966) and logistic (0.874-0.963) models. The logistic model calibrated well from the first until the 13th postoperative day (0.997-1.002), but the additive model over- or underestimated mortality risk (0.626-1.193).The logistic model shows statistical superiority. Because of the precise weighing the individual risk factors, it offers a reliable risk prediction. It is easier to interpret and to facilitate the integration of mortality risk stratification into the daily management more than the additive one.

Chronic β-blockade has evolved to an important therapeutic strategy in medicine. Not all its therapeutic effects may be explained by its direct action on the β-adrenergic system. We therefore investigated if chronic β-blockade in vivo or in isolated cell systems may modulate also inhibitory receptors of the adenylyl cyclase system. Chronic treatment with metoprolol for 6 days (10 mg/day) induced an increase of β-adrenergic receptors in rat cardiac plasma membranes (53 ± 8 vs 80 ± 12 fmol/mg protein). Simultaneously the density of cardiac muscarinic M2 receptors decreased significantly from 150 ± 17 to 110 ± 12 fmol/mg protein without any change of the affinity of the receptors for their agonists or antagonists. By this mechanism chronic β-blockade leads to an unexpected impairment of the muscarinic-mediated inhibition of the adenylyl cyclase. This transregulation of inhibitory receptors by chronic β-blockade was not restricted to the heart but also reduced the muscarinic receptors of rat lung (35 ± 4 vs 24 ± 3 fmol/mg protein). Additionally, other inhibitory receptors of the adenylyl cyclase system such as the A1 adenosine receptors of rat brain were reduced by chronic β-blockade (532 ± 32 vs 444 ± 26 fmol/mg protein). This transregulation of A1 adenosine receptors occurred only after chronic β-blockade with the active stereoisomer (−)-metoprolol whereas the (+)-isomer was ineffective. The ability of the remaining A1 adenosine receptors to form the agonist-promoted high affinity state was unaltered. Their reduction, however, was sufficient to abolish the phenylisopropyl-mediated inhibition of the adenylyl cyclase. To evaluate if this regulation of various inhibitory receptors in different organs may represent a general cellular regulation mechanism, we investigated whether this transregulation also occurred in isolated cells. Isolated smooth muscle cells derived from the vas deferens (DDT1 MF-2) were cultivated in the presence of the β-blocker atenolol (10−5 m ) for 3 days. Chronic β-blockade in these isolated cells induced an increase of β-adrenergic receptors and concomitantly a significant decrease of A1 adenosine receptors (460 ± 42 vs 368 ± 18 fmol/mg protein). The affinity of the A1 adenosine receptors for their agonists and antagonists and the ability of the remaining receptors to form the agonist-promoted high affinity state remained unaltered. In contrast, the reduction of receptor density greatly impaired the adenosine-mediated inhibition of the adenylyl cyclase. These data demonstrate that chronic β-blockade leads to a functionally significant reduction of inhibitory receptors of the adenylyl cyclase system. This newly characterized transregulation of inhibitory receptors of the adenylyl cyclase system by chronic β-blockade represents a new regulation mechanism which involves several inhibitory receptor systems and occurs at the cellular level. This transregulation may explain some of the therapeutic effects of the little understood chronic β-blockade.

Home Care Telemedicine is a rapidly developing application in clinical medicine where medical information is transferred via telephone or Internet for the purpose of disease management.

For the molecules CO, N 2 and O 2 the cross sections for the electron impact triple and quadruple ionization have been measured from threshold up to an electron energy of 1 keV. The cross sections are compared with the total electron impact ionization cross section. For the triply ionized molecules the initial kinetic energy of the fragment ions is measured and appearance energies are determined.

To evaluate the diagnostic value of multidetector CT angiography (MDCTA) of the renal arteries.27 patients underwent MDCTA of the renal arteries. Scan parameters were: collimation 4 x 1 mm, pitch 1.5, effective slice thickness 1.25 mm, reconstruction increment 0.8 mm, circulation time measurement, power injection of 80 ml iomeprol 400, flow 4 ml/sec. Independent reading on laser film was done by two radiologists using edited maximum intensity projections, multiplanar reconstructions and source images. Standard of reference was a 3D-FLASH MR angiography (1.5 T, 3.9/1.2, 10 degrees 0.2 mmol GdDTPA/kg bw) in 10 and intraarterial angiography in 17 patients.Analysing 63 arteries, sensitivity, specificity, positive predictive value and negative predictive value in terms of detection of moderate and high grade renal artery stenosis (n = 10) were 90, 98, 90 and 98 % for reader A, and 90 % each for reader B, respectively (kappa = 0.91 interobserver agreement). 1/11 accessory renal arteries was missed by both angiography and MDCTA. Image quality was graded as excellent or good in 26/27 of cases by both readers.MDCTA proved to be a highly accurate tool in the detection of therapeutically relevant renal artery stenosis.

Photoelectron-photoion coincidence measurements on the methyl halide ion dissociations show that when these ions are formed in different electronic states they undergo specific reactions to different products. Some interconversion between electronic states also occurs to an extent which correlates with the energy gaps between the states concerned. Within certain states the vibrational energy is not statistically redistributed before fragmentation.

Branching ratios for fragmentation to different products and kinetic energies released in dissociation have been measured as functions of the internal energy of the parent ions of propane and neopentane using the photoelectronphotoion coincidence technique. The results affirm the statistical fragmentation model for propane ions and suggest it in the case of neopentane ions.

The mass spectra of doubly charged ions of the hydrocarbon molecules ethene, difluorethene, propane, propene, cyclopropane, propyne, allene, 1,3-butadiene, 2-butene ( cis ), benzene, and cyclohexane have been recorded. For some of them, appearance energies of doubly charged fragments could be measured. In the case of benzene, we even observed the triply charged molecular ion.

Vom 25. bis 29. Marz hielten die DPG-Fachausschusse bzw. Arbeitsgemeinschaften Quantenoptik, Plasmaphysik, Molekulphysik, Kurzzeitphysik, Oberflachenphysik, Massenspektrometrie ihre Fruhjahrstagung in der Universitat Bayreuth ab. 1030 Teilnehmer, darunter viele aus dem Ausland, waren in die Wagner-Stadt gekommen, und sie haben sich ohne Zweifel wohlgefuhlt in den ansprechenden Raumen der „NW I und II” (Naturwissenschaftliche Fakultat I und II) und im Stadtchen. Unauffallig und souveran organisiert von J. Friedrich, D. Haarer, A. Laubereau, Frau R. Muller und M. Schwoerer gingen 11 Plenar-, 11 Haupt- und 43 Fachvortrage sowie 453 Kurzberichte, 78 Posterbeitrage, 3 Fortbildungsvortrage und ein offentlicher Abendvortrag uber die diversen Buhnen. Auch die fast 40 Gerate-und Buchaussteller konnten zufrieden sein: Zumindest im zentralen Foyer der NW I waren ihre Stande nahezu ohne Pause gut besucht. Eines regen Interesses erfreuten sich auch die drei Fortbildungsvortrage von F. Frungel (Hamburg) uber Einsatzmoglichkeiten der photographischen Bewegungs-analyse in sehr kurzen Zeiten, von H. J. Pfeifer (Saint Louis) uber Laser-Doppler-Anemometrie in der Stromungsforschung und von A. Laubereau (Bayreuth) uber Erzeugung und Anwendung von ultrakurzen Laserimpulsen. In dieser Form — mit Referenten, die gut vorbereitet sind und glanzend vortragen, in einem zentral gelegenen Horsaal und zu gunstiger Zeit — sind Fortbildungsveranstaltungen ein wirklicher Gewinn fur die Zuhorer und eine Werbung fur die Physik. Beim offentlichen Abendvortrag von G. Wegner aus dem MPI fur Polymerforschung in Mainz mit dem Titel „Molekulare Architektur — Konzepte der Polymerforschung” waren im Emil-Warburg-Horsaal noch einige Platze frei geblieben. Mit ihrer Einladung an die Bayreuther Offentlichkeit, in den „Emil-Werbung-Horsaal” zu kommen, hatte dazu vermutlich auch die ortliche Tageszeitung beigetragen. Wegner wies in seinem sehr anschaulichen Vortrag eindringlich darauf hin, wie wichtig die Intensivierung einer fruchtbaren Zusammenarbeit von Chemikern und Physikern bei der Erforschung der unkonventionellen, vor allem der elektronischen Eigenschaften der Polymere ist. Einer moglichen Langeweile am Abend hatten die Organisatoren mit einem sehr ansprechenden Rahmenprogramm vorgebeugt. Neben Zunftigem (Besuch der Grosbrauerei Maisel mit ihrem hervorragenden Brauereimuseum und anschliesendem frankischen Abendessen) stand Erlesenes zur Wahl: ein Konzert der Capella Antiqua Bambergensis mit heiterer Musik aus Mittelalter, Renaissance und Barockzeit im Markgraflichen Opernhaus unter der Leitung von Prof. Dr. W. Spindler. Gespielt wurde auf historischen Instrumenten wie Krummhornern, Gemshornern, Blockfloten, pommern, Rauschpfeifen, Dulciane, Gamben, Schlagwerk. Fur Wagner-Freunde war die Wallfahrt zum Haus Wahnfried (Wagner-Museum) und zum Festspielhaus unter der kompetenten und charmanten Fuhrung der Wagner-Kennerin Irmgard Pflaum eine bare Selbstverstandlichkeit. Die restliche Musik war durch Werke von Mayuziumi, Tschaikovsky und Dvořak reprasentiert, und zwar in einem Konzert der Bamberger Symphoniker.

The 21.22-eV photoelectron spectrum has been measured from a barium beam. Aside from the ground state of Ba + , the first six excited states of this ion have been identified. An unusually high relative cross section for the production of Ba 2+ and excited Ba + compared to Ba + in its ground state is found. An explanation is proposed involving the autoionizing (5p) 5 (6s) 2 2 P 1/2 state of Ba + . From this the binding energy of the 5P 1/2 electrons of Ba is found to be 21.1 eV.

Detailed integral cross sections of processes H + M → H−, H+ + e + M, H + e + M+ (M  Ne,Ar,Kr,Xe,O2) are reported in the low energy region (E < 100 eV or E < 500 eV for M+ + e). In general, ion pair formation is the dominating process at low energy and has a stongly oscillating cross section; free electron cross sections are monotonously rising.

The decay of doubly-charged molecular ions, produced by electron impact is investigated by a new method. The singly-charged decay products and their kinetic energy distributions are measured in coincidence as a function of the energy of the ionizing electrons up to 1000 eV. Results for H2, N2, O2, CO and NO are presented.