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Die arthroskopisch assistierte Tibiakopffrakturosteosynthese ermoglicht eine genaue Einschatzung der Gelenkimpression sowie der intraartikularen Spalt- und Stufenbildung. Zusatzlich kann therapeutisch unter arthroskopischer Sicht die Fragmentreposition und das Anheben der Impression auf das Gelenkniveau uberwacht werden. Die Ziellehre aus der VKB-Chirurgie erscheint hilfreich, wenn Gelenkfragmente des Tibiakopfes anzuheben sind. Unter arthroskopischer Sicht lasst sich ein Fuhrungsdraht in dem Defektbereich positionieren, uber den mittels Dilatator das Imprimat angehoben wird. Die Gelenkflache lasst sich besser arthroskopisch als mittels Fluoroskopie beurteilen. Das Gleiche trifft fur reponierte Spaltbruche zu. Begleitverletzungen, wie vordere Kreuzbandrupturen oder Meniskuslasionen, konnen diagnostiziert werden. Liegt ein Meniskusriss vor, so kann dieser sofort arthroskopisch genaht werden.

During a simulation study a cognitive assistant (COGAS) is being developed for supporting the crew of a combat information centre (CIC) on Navy ships during air target identification. This contribution describes the functional structure of COGAS and its various model components. Furthermore, the simulated task structure of COGAS and the crew members will be explained.

Drug treatment is critical in pregnant cows due to the possibility of a maternal-to-fetal drug transfer across the placenta. Since the (syn)epitheliochorial bovine placental barrier includes an intact uterine epithelium, which in general limits drug transfer to the fetal trophoblast, the establishment of a species- and organ-specific in vitro model like the bovine caruncular epithelial cell line 1 (BCEC-1) for testing bovine placental drug transport is desirable. P-glycoprotein (P-gp or ABCB1) is an important efflux carrier that limits drug permeability across blood-tissue barriers such as the placenta and transports a wide range of structurally unrelated compounds including many drugs commonly used in veterinary medicine. The aim of the present study was to elucidate the suitability of BCEC-1 as an appropriate in vitro model for P-gp mediated drug transport in the bovine placenta. P-gp mRNA expression was detected by RT-PCR in BCEC-1 and placental tissue. Additionally, the carrier protein was localised in the apical membrane of BCEC-1 by immunofluorescence staining with the mouse monoclonal antibody C494. Drug transport in BCEC-1 was investigated by FACS analysis using the fluorescent P-gp substrate Rhodamine 123. Inhibition of Rhodamine 123 efflux by the P-gp inhibitors Verapamil and PSC833 confirmed functional expression of P-gp in BCEC-1. Furthermore, transport measurements in the transwell-system revealed a basal-to-apical net flux of the P-gp substrate digoxin at concentrations ranging from 10nM to 10 μM. This transwell digoxin flux was inhibited by Verapamil. In conclusion, P-gp is functionally expressed in BCEC-1 and mediates a basal-to-apical flux of digoxin indicating dominant apical localization of P-gp in this cell culture model. Therefore, BCEC-1 may be an appropriate in vitro model to study drug transport across the maternal epithelium as part of the epitheliochorial placental barrier of the cow.

The human three-dimensional in vitro model Skin(2) ZK 1350(TM) [Advanced Tissue Sciences (ATS), La Jolla, USA] was tested for two in vitro toxicology applications, prediction of phototoxicity and classification of skin corrosivity. For phototoxicity testing chemicals were applied topically for 1 or 24 hr followed by 30 min of irradiation with a non-irritating dose of UVA. Phototoxicity was assessed 24 hr later by comparing cytotoxicity of UVA-exposed and non-exposed tissue in the MTT assay. In a European EC/COLIPA in vitro phototoxicity validation trial with 20 test chemicals (11 phototoxic and nine non-phototoxic), the best result was obtained with the Skin(2) ZK 1350 assay in the 24-hr exposure protocol where nine of the 11 phototoxins were classified correctly both at ATS and ZEBET. 6-Methylcoumarin could only be identified as a phototoxin when applied through the medium to the dermis side of the skin model for 24 hr. All of the nine non-phototoxic chemicals were identified correctly with either 1- or 24-hr preincubation. To classify chemicals as corrosive to the skin with an in vitro assay, ZEBET and two other laboratories tested 50 chemicals under blind conditions in the Skin(2) ZK 1350 model within a European ECVAM validation trial. The results obtained with the ZK 1350 assay showed a satisfactory classification of skin corrosive/non-corrosive chemicals and a sufficient prediction of the three UN Packing Groups for corrosive chemicals. Predictions obtained at ZEBET with the Skin(2) ZK 1350 model (sensitivity: 64%, specificity: 76%; positive and negative predictive values: 68%) compared with a sensitivity of 81% and a specificity of 77% as mean values for the three laboratories testing the model.

In a joint validation project eight laboratories from the European Cosmetic Industry Association (COLIPA) as well as FRAME (England) and ZEBET (Germany) are trying to develop validated in vitro methods to be incorporated into new international guidelines for acute phototoxicity testing. The first stage of the study involved selection of the most promising in vitro phototoxicity tests for further validation. 20 chemicals with known phototoxic properties (12 phototoxins, four UV-absorbing non-phototoxins and four non-UV absorbing non-phototoxins) were tested under identical conditions of UV exposure conditions (sun simulator, UVA 5 J/cm(2)) in a standardized cytotoxicity assay with Balb/c 3T3 fibroblasts (endpoint: neutral red uptake, NRU). 19 of the 20 chemicals were correctly classified by the 3T3 NRU phototoxicity test, and therefore, this simple assay for phototoxicity seems very promising and should be validated further.

The bovine placenta produces large amounts of steroids, mainly estrone (E1) and progesterone (P-4). Specific features of bovine placental steroidogenesis are I) the expression of all enzymes needed for the production of estrogens from cholesterol in the trophoblast 2) an only marginal and temporal contribution to peripheral maternal P4 levels restricted to a period between approx. days 150-240 of gestation 3) the predominance of sulfoconjugated over free El and 4) a complementary setting of steroidogenic enzymes in the two morphologically discriminable trophoblast cell types, the uninucleated trophoblast cells (UTC) and the trophoblast giant cells (TGC). In cattle so far no definite information is available on the specific biological roles of placental estrogens and P4. However, the detection of estrogen receptors and progesterone receptors in the placentomes Suggests a role primarily as local regulators of caruncular growth, differentiation and functions. Inconsistent with a function as a caruncular growth factor is the strong evidence that in cattle placental estrogens enter the maternal compartment almost completely as estrone Sulfate (EIS), which is not active at classical nuclear receptors. Oil the other hand, E IS may be converted locally to free active estrogens via the action of steroid sulfatase (StS), which has been detected in specific parts of the bovine carancular epithelium. Alternatively or in addition, StS expression in the caruncular epithelium may serve the utilization of sulfated neutral steroid precursors (e.g. pregrienolone sulfate or cholesterol sulfate) supplied with maternal blood, thus providing free substrates for further metabolization in the adjacent trophoblast. The down-regulation of P450scc and P450c17 and the Up-regulation of 3B-HSD and aromatase during the differentiation of TGC from UTC in parallel with the up-regulation of ERE and estrogen sulfotransferase in maturing TGC suggests a function of placental estrogens primarily as auto-or intracrine regulators during this process and assigns to conjugated placental estrogens a role as inactivated by-products of TGC differentiation intended for excretion. Collectively, despite some evidence from recent studies for putative roles of placental steroids in cattle their exact functions in the bovine species remain still undefined. German Research Foundation (DFG) The Ewald and Hilde Berge Foundation

We report on a 21-year old patient who nearly drowned in cold water under inexplicable circumstances. About 1/2 hour later he was found with cardiac arrest. Immediate cardiopulmonary resuscitation remained unsuccessfully but was continued. After transportation to the nearest hospital a core temperature of 26.1 degrees C was recorded. A team of our hospital arrived 2 1/2 hours after start of cardiopulmonary resuscitation. After introducing a femo-femoral bypass the patient was rapidly rewarmed and oxygenated using a portable extracorporeal circulation and membrane oxygenation. Defibrillation succeeded at a core temperature of 34.4 degrees C. A severe ARDS developed the same day which was successfully treated by membrane oxygenation. 41 days later the patient left the hospital fully recovered.

From September 1987 to September 1994 61 patients between 29 and 78 years of age received mechanical circulatory support by means of the Biomedicus centrifugal pump. The patients were divided into three groups by indication: Group I included 15 patients with early postcardiotomy cardiogenic shock and 24 patients with late postcardiotomy cardiogenic shock. Group II 11 patients with therapy-resistant cardiogenic shock following acute myocardial infarction, and Group III 11 patients with cardiogenic shock of other etiologies. Duration of support was 1 to 347 hours. Survival rates were 46.7% and 33.3% in patients with early and late postcardiotomy cardiogenic shock, respectively (Group I), 27.2% in Group II, and 18.1% in Group III. Most frequent complications were bleeding (40%, 58%) and acute renal failure (26.7%, 29.2%) in Group I and multiple organ failure in Groups II and III (64% and 45.5%). Major causes of death were bleeding and multiple organ failure in Group I (37.5%) and multiple organ failure in Groups II and III (87.5% and 50%). Groups II and III (87.5% and 50%).

The present definitions of low-output syndrome (LOS) associated with cardiac surgery are based on data obtained via the Swan-Ganz-catheter. However, further important data such as signs of chronic renal insufficiency, arterial vascular disease, and perioperative volume overload have hardly been considered. At the Heart Center NRW, FRG, the Swan-Ganz-Catheter is not used routinely to monitor patients following cardiac surgery. According to our experience, the definition of low-output syndrome includes a wider spectrum of relevant criteria. In addition to the data obtained by means of a central venous catheter the clinical aspect of the patient as well as laboratory analysis should be regarded as well. In 1259 consecutive patients (pts) (914 with coronary surgery and 318 with valve surgery) the incidence and mortality of low-output syndrome were determined. In 49 of the 941 coronary surgery pts (5.2%) a postoperative low-output syndrome occurred. Nine pts (0.95%) died as a result of this complication. According to our therapeutical strategy, the low-output syndrome was treated medically in 28 pts (2.9%); in 14 pts (1.5%) IABP implantation was necessary, and 7 pts needed mechanical circulatory support. Surprisingly, the same incidence of LOS occurred in the valve surgery group of pts as in the coronary group. We saw a low-output syndrome in 17 of the 318 pts (5.3%), with fatal outcome in three pts. In 14 of these pts (4.4%) the LOS was treated medically, while the remaining three pts (0.9%) required diastolic augmentation of the IABP.

(1993). Sleep wakefulness cycle. Journal of Interdisciplinary Cycle Research: Vol. 24, No. 4, pp. 263-264.

In a simulation study, conducted to determine information flow at a pilotcockpit interface during an automated landing approach, a mathematical model of pilot's supervisory control tasks was developed. For modeling those tasks and their network combination, production systems were used and described with general systems theory formalisms. For that the pilot was considered as a sequential input/output system and described with input, output, internal, and memory variables. While performing a task, only subsets of all variables and of their value sets are required. For describing the pilot's selection behavior, selection functions were introduced which specify task relevant variables and their values. From task relevant variables, behavior relevant variables are derived. Then the task performance behavior of the pilot can be described with binary relations among all value sets of behavior relevant variables which are task specific and invariant during the duration of a task. Each relation element represents an ordered pair of coordinates of which the first describes the left situation side of a production rule and the second its right action side. The resulting model guides the required task analysis and supports the development of a simulation program.

A simulation study was conducted for determining information flow requirements of a pilot-cockpit interface during an ILS-approach. The steps of the study for modeling, simulating, and analyzing system processes are discussed. Starting with the definition of the problem which includes the relevant flight processes, the network of pilot tasks, and the performance measures, the conceptual model of processes is mathematically described by means of algebraic and difference equations as well as production systems. To transform the model into a simulation program, the simulation language SLAM is used. SLAM elements utilized for modeling flight processes and pilot activities as well as the procedure of model validation are discussed. The analysis of simulation output data results in the determination of important information requirements useful in a design project such as range of variables to be indicated or affected, frequency and sequence of variables used by the pilot, pilot tasks, duration of task variables, and the average utilization rate of cockpit display and control components.

A constructive semilocal existence theorem for the function F: C → C F(x)≔ ∑ k=1 ∞ 1 k sin x k , called Flett's function is given. The constructive part of the theorem consists of an efficient numerical procedure to compute the zeros of F; its efficiency is based on special properties of F. For the real zeros a way is shown how to find starting approximations. It is illustrated by an example that the error estimate obtained is very sharp.

A simulation study was conducted for determining information flow requirements of a pilot-cockpit interface during an ILS-approach. Study steps for modeling, simulating, and analyzing system processes are discussed. Starting with the problem definition which includes relevant flight processes, the network of pilot tasks, and performance measures, the conceptual model of processes is mathematically described by means of algebraic and difference equations as well as production systems. To transform the model into a simulation program, the simulation language SLAM is used. SLAM elements utilized for modeling flight processes and pilot tasks as well as the procedure of model validation are discussed. The analysis of simulation output data, i.e. state trajectories and task timelines, results in the determination of important information requirements useful in early stages of a design project.

10 Kinder des ersten Lebensjahres wurden in drei verschiedenen Temperaturbereichen zwischen 20 und 33°C Larmreizen von 70–90 dB(B) ausgesetzt. Bei Umgebungstemperaturen von 20–28°C wurden akustische Belastungen mit uber 80 dB(B) in Frequenzen von 100–7000 Hz vom uberwiegenden Teil der Sauglinge mit einer peripheren Vasoconstriction beantwortet. In einer Umgebungstemperatur von uber 30°C tritt eine periphere Vasoconstriction erst bei Larmbelastungen von 90 dB(B) ein. Diese Verminderung der Hautdurchblutung hielt bei der Mehrzahl der Probanden nur kurzzeitig an; noch wahrend der Larmphase folgte darauf eine periphere Vasodilatation. Die Bedeutung der erhobenen Befunde wird besprochen.

1. 51 schlafende Sauglinge wurden wahrend der Vormittagsstunden und Nachtstunden kurzzeitig einem Mischlarm von 90–7000 Hz ausgesetzt. Dabei registrierten wir mit einem Henselschen Fluvographen den Verlauf der peripheren registrierten wir mit einem Henselschen Fluvographen den Verlauf der peripheren Durchblutungsschwankungen an der Stirn und am linken Handrucken 2. Unter einem Schallpegel von 60 und 65 dB(B) reagierte kein Saugling mit einer Anderung des peripheren Hautwiderstandes. Erst bei einer Larmintensitat von 70 dB(B) antwortete etwa ein Drittel und von 80 dB(B) ungefahr zwei Drittel der Probanden mit einer Verminderung des peripheren Hautwiderstandes. Wurden 90 dB(B) erreicht, kam es obligat zu einer Vasoconstriction. Dabei bestand kein Unterschied zwischen den Tag-und Nachtmessungen. Aus der Starke der auf einen Larmreiz hin einsetzenden Vasoconstriction konnte nicht auf die einwirkende Lautstarke ruckgeschlossen werden. 3. Die periphere Vasoconstriction trat regelmasig wenige Sekunden nach Einschalten der Larmquelle ein. Das Maximum dieser Reaktion wurde in der 2. min der Larmeinwirkung registriert. Nach Beendigung des Larmreizes bildete sich die periphere Durchblutung schnell wieder zu den Ausgangswerten zuruck. In einem grosen Teil der Falle trat diese Ruckbildung jedoch schon wahrend der Larmphase ein. Im Gegensatz hierzu bleibt bei Erwachsenen die Gefasverengerung wahrend der ganzen Larmphase bestehen. 4. Bei wiederholt auftretenden, hochfrequenten und lauten Gerauschen machen sich beim Saugling Schreckreaktionen bemerkbar. Es bleibt dann fur mehrere Minuten eine sympathicotone Reaktion unverandert bestehen. Offenbar erzeugen mehrfache, kurze Larmreize dieser Art einen Kumulationseffekt.

In two groups of infants (3–53 weeks old) skin temperatures were controlled in different areas of the trunk—i.e.: regions of sternum, lungs, heart, liver, spleen, kidneys—at different room-temperatures (group I: 21–25°C; group II: 29–32°C). Rectal temperatures of some probands in both groups also had been controlled simultaneously. A definite change in the reaction to heat was proofed in different periods of the first year of life. In higher environmental temperatures the skin temperature was almost constant at every controll-point of the skin, even in older infants. In lower environmental temperatures the skin temperatures lowered continuously with age till 7. to 9. moth. From 10. to 12. month the lowering of skin temperature discontinued. The rectal temperatures were relatively constant in all infants. Only in infants from 7. to 12. month, whose skin temperatures were controlled in lower as well as in higher environmental temperatures, a tendency to higher rectal temperatures was proofed in warmer environmental temperatures.

1. Es wird uber Untersuchungen des vasomotorischen Verhaltens der Korperperipherie von Sauglingen unter lokaler Strahlungs-Warme-Applikation auf ein umschriebenes Hautareal berichtet. 2. Die Messungen wurden an 39 Sauglingen bei Ultrarot-Bestrahlung eines Hautfeldes des linken Handruckens von 1 oder 4 cm2 uber 1 und 2 min Dauer aus 50 cm bzw. 1 m Distanz vorgenommen. Die periphere Hautdurchblutung wurde mit einem Henselschen Fluvographen an der Stirnhaut und am rechten Handrucken registriert. An beiden Handrucken wurde auserdem die Hauttemperatur mit Thermoelementen bestimmt. 3. Die hier angewandte geringe Warmestrahlung fuhrte bei der uberwiegenden Zahl der Probanden zu einer peripheren Gefasdilatation und zum Temperaturanstieg in Hautbereichen innerhalb und auserhalb des Bestrahlungsfeldes. Fur ihr Eintreten war im wesentlichen die Dauer der exogenen Warmebelastung masgebend. Quantitative Aussagen lassen diese Untersuchungen nicht zu; es wurden lediglich qualitative Erkenntnisse gewonnen. 4. Die Bedeutung der Befunde fur die Benutzung von Strahlungswarmegeraten in der Sauglingspflege wird umrissen.

A simulation study was conducted for determining information flow requirements of a pilot-cockpit interface during an ILS-approach. The steps of the study for modeling, simulating, and analyzing system processes are discussed. Starting with the definition of the problem which includes the relevant flight processes, the network of pilot tasks, and the performance measures, the conceptual model of processes is mathematically described by means of algebraic and difference equations as well as production systems. To transform the model into a simulation program, the simulation language SLAM is used. SLAM elements utilized for modeling flight processes and pilot activities as well as the procedure of model validation are discussed. The analysis of simulation output data results in the determination of important information requirements useful in a design project such as range of variables to be indicated or affected, frequency and sequence of variables used by the pilot, pilot tasks, duration of task variables, and the average utilization rate of cockpit display and control components.

Bei modernen Systemen der Fahrzeug- und Prozesfuhrung, z.B. bei Schiffsfuhrungszentralen, Flugzeugcockpits und Kraftwerkswarten, lassen sich seit, einiger Zeit zwei Tendenzen beobachten: Zum einen eine zunehmende Komplexitat, zum anderen eine damit verbundene zunehmende Automatisierung. Komplexe Systeme sind dadurch gekennzeichnet, das sie sich aus vielen unterschiedlichen Elementen, z.B. Menschen, Maschinen, Rechnern, usw., zusammensetzen, die ihrerseits durch eine grose Anzahl verschiedenartiger Beziehungen miteinander verknupft sind /l/. Die erhohte Komplexitat fuhrt zu wachsenden Schwierigkeiten bei der Entwicklung dieser Systeme und in zunehmendem Mase zu Storungen bei ihrem Einsatz. Mit steigender Automatisierung tritt eine Qualitatsanderung bei den Aufgaben ein, die der Mensch durchzufuhren hat. Das vorwiegend korperliche Handeln des Menschen wird in diesen Systemen immer mehr verdrangt durch mentale Entscheidungs- und Uberwachungsaufgaben /2/.

Als 1975 die Substanz Natrium-Cellulose-Phosphat (NCP) als neue therapeutische Moglichkeit in der Rezidiv-Prophylaxe calciumhaltiger Nierensteine in der Bundesrepublik eingefuhrt wurde, lagen erste Erfahrungsberichte aus 11 Veroffentlichungen an insgesamt 142 Patienten aus England, den USA und Spanien vor. Es war daher das Ziel unserer Untersuchungen, die therapeutische Wirksamkeit einer bis dahin noch wenig abgesicherten Medikation zu uberprufen. Wahrend die erwahnten Arbeiten mehr den Charakter von Erfahrungsberichten an kleinen Patientenkollektiven hatten, sollten die von uns aufgenommenen Untersuchungen ausreichend grose Patientengruppen umfassen, um statistisch gesicherte Ergebnisse zu ermoglichen.

In a simulation study, conducted to determine information flow at a pilotcockpit interface during an automated landing approach, a mathematical model of pilot's supervisory control tasks was developed. For modeling those tasks and their network combination, production systems were used and described with general systems theory formalisms. For that the pilot was considered as a sequential input/output system and described with input, output, internal, and memory variables. While performing a task, only subsets of all variables and of their value sets are required. For describing the pilot's selection behavior, selection functions were introduced which specify task relevant variables and their values. From task relevant variables, behavior relevant variables are derived. Then the task performance behavior of the pilot can be described with binary relations among all value sets of behavior relevant variables which are task specific and invariant during the duration of a task. Each relation element represents an ordered pair of coordinates of which the first describes the left situation side of a production rule and the second its right action side. The resulting model guides the required task analysis and supports the development of a simulation program.

In a case of open heart surgery a temperature probe was inserted orally to monitor the temperature in the esophagus. After insertion, the arterial oxygen tension decreased. Fiberoptic examination of the bronchial system revealed an obstruction in the right main bronchus by the temperature probe. After removal of the probe normal oxygenation was restored.

Als 1975 Natrium-Zellulose-Phosphat (NCP) zur Rezidiv-Prophylaxe kalziumhaltiger Nierensteine in der Bundesrepublik eingefuhrt wurde, begannen wir uber 100 Trager kalziumhaltiger Steine, die meist schon Steinoperationen hinter sich hatten, praoperativ wechselweise drei gleichgrosen Kollektiven zuzuordnen. Wahrend alle Patienten gleichermasen angeleitet wurden, ihre tagl. Urinmenge auf mindestens 1500 ml zu steigern und eine kalziumreduzierte Ernahrung nach Diatplan durchzufuhren, erfolgte die Medikation zur Rezidivstein-Prophylaxe unterschiedlich: Die 1. Gruppe nahm 3 × tg1. 30 Tropfen Nieron. Die 2. Gruppe erhielt taglich 10–15 g NCP und zwar zu allen Hauptmahlzeiten 5 g und zu allen kleinen Mahlzeiten 2,5 g. Die 3. Gruppe erhielt gleichzeitig 10–15 g NCP und 50 mg Hydrochlorothiazid (Esidrix), abends. Gruppe I, mit Nieron, sollte den Charakter einer neutralen Vergleichspruppe haben.

The effect of recent U.S. Court decisions and of executive, congressional, and state actions will be to cut off public funds for abortion services. This impact will fall most severely on the poor, especially black, teenage, unwed, and rural poor. Charts are presented which show the disproportion among states of abortion availability and expenditure. A virtual cutoff of public abortion funds will affect the estimated 300,000 poor women annually who receive Medicaid-funded abortions, the 150,000 other low-income women whose abortions are subsidized by clinics or hospitals, and the estimated 424,000 needy women unable to obtain abortion services because of Medicaid restrictions or inaccessibility. More than 3 million Medicaid-eligible women of reproductive age are at risk of unwanted pregnancy. Teenage illegitimacy and unwanted pregnancies will certainly rise, as will pregnancy-related morbidity and mortality. The final result of these recent decisions and actions will be soaring public expenditures for health and welfare payments.

In patients with recurrent idiopathic nephrolithiasis we studied whether treatment with sodium cellulose phosphate leading to decreased intestinal calcium absorption could induce secondary hyperparathyroidism and whether thiazides which diminish calciuria would impair glucose tolerance. After removal of a actual kidney stone, 74 patients were treated for one year as follows: 25 (group 1) received conventional therapy (Nieron), 22 (group 2) received sodium cellulose phosphate, and 27 (group 3) received sodium cellulose phosphate plus hydrochlorothiazide. The period of one year was too short to evaluate the effectiveness of treatment regarding stone recurrence, however, a significant decrease in calciuria only was seen in group 3. With respect to the possibility to develop secondary hyperparathyroidism, group 2 and group 3 did not reveal any hints. In group 3, the thiazide treatment did not worsen glucose tolerance. Therefore, longer lasting studies with these drugs could be performed without evident danger to develop the mentioned side effects.