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Zusammenfassung Hintergrund Sprachtherapeutisch-linguistische Fachkreise empfehlen die Anpassung einer von einem internationalen Konsortium empfohlenen Änderung der Nomenklatur für Sprachstörungen im Kindesalter, insbesondere für Sprachentwicklungsstörungen (SES), auch für den deutschsprachigen Raum. Fragestellung Ist eine solche Änderung in der Terminologie aus ärztlicher und psychologischer Sicht sinnvoll? Material und Methode Kritische Abwägung der Argumente für und gegen eine Nomenklaturänderung aus medizinischer und psychologischer Sicht eines Fachgesellschaften- und Leitliniengremiums. Ergebnisse Die ICD-10-GM (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification) und eine S2k-Leitlinie unterteilen SES in umschriebene SES (USES) und SES assoziiert mit anderen Erkrankungen (Komorbiditäten). Die USES- wie auch die künftige SES-Definition der ICD-11 (International Classification of Diseases 11th Revision) fordern den Ausschluss von Sinnesbehinderungen, neurologischen Erkrankungen und einer bedeutsamen intellektuellen Einschränkung. Diese Definition erscheint weit genug, um leichtere nonverbale Einschränkungen einzuschließen, birgt nicht die Gefahr, Kindern Sprach- und weitere Therapien vorzuenthalten und erkennt das ICD(International Classification of Disease)-Kriterium, nach dem der Sprachentwicklungsstand eines Kindes bedeutsam unter der Altersnorm und unterhalb des seinem Intelligenzalter angemessenen Niveaus liegen soll, an. Die intendierte Ersetzung des Komorbiditäten-Begriffs durch verursachende Faktoren, Risikofaktoren und Begleiterscheinungen könnte die Unterlassung einer dezidierten medizinischen Differenzialdiagnostik bedeuten. Schlussfolgerungen Die vorgeschlagene Terminologie birgt die Gefahr, ätiologisch bedeutsame Klassifikationen und differenzialdiagnostische Grenzen zu verwischen und auf wertvolles ärztliches und psychologisches Fachwissen in Diagnostik und Therapie sprachlicher Störungen im Kindesalter zu verzichten.

The treatment options for patients with metastatic melanoma (MM) have been dramatically expanded in recent years with the approval of new drugs. The MEK (mitogen-acitvated protein kinase kinase) and BRAF (serine/threonine-protein kinase B-Raf coding gene) inhibitor combination therapy is currently part of the standard of care for stage IIIC/IV of BRAF mutant melanoma. The MEK inhibitor-associated retinopathy (MEKAR) is observed in patients with MM who are treated (or have been treated) with such a combination therapy. This article reports the case of a 72-year-old male patient, who suffered from such a pathological condition under treatment with binimetinib in combination with nivolumab. This case study illustrates the importance of interdisciplinary collaboration in the treatment of MM patients.Die Behandlungsmöglichkeiten für Patienten mit metastasierendem Melanom (MM) wurden in den letzten Jahren mit der Zulassung von neuen Medikamenten dramatisch erweitert. Die MEK(mitogen-aktivierte Proteinkinase-Kinasen)- und BRAF(Serin/Threonin-Kinase B-Raf kodierendes Gen)-Hemmer-Kombinationstherapie gehört aktuell zum Versorgungsstandard für das Stadium IIIC/IV des BRAF-mutierten Melanoms. MEKAR (MEK-Inhibitor-assoziierte Retinopathie) werden bei Patienten mit metastasierendem Melanom beobachtet, die mit einer solchen Kombinationstherapie behandelt werden bzw. wurden. Wir berichten über den Fall eines 72-jährigen Patienten, der eine solche Pathologie unter der Therapie mit Binimetinib in Kombination mit Nivolumab erlitt. Diese Kasuistik verdeutlicht die Wichtigkeit einer interdisziplinären Zusammenarbeit bei der Behandlung von MM-Patienten.

Background After two decades of transcranial direct current stimulation (tDCS) research, it is still unclear which applications benefit most from which tDCS protocols. One prospect is the acceleration of learning, where previous work has demonstrated that anodal tDCS applied to the right ventrolateral prefrontal cortex (rVLPFC) is capable of doubling the rate of learning in a visual camouflaged threat detection and category learning task. Goals Questions remain as to the specific cognitive mechanisms underlying this learning enhancement, and whether it generalizes to other tasks. The goal of the current project was to expand previous findings by employing a novel category learning task. Methods Participants learned to classify pictures of European streets within a discovery learning paradigm. In a double-blind design, 54 participants were randomly assigned to 30 min of tDCS using either 2.0 mA anodal (n = 18), cathodal (n = 18), or 0.1 mA sham (n = 18) tDCS over the rVLPFC. Results A linear mixed-model revealed a significant effect of tDCS condition on classification accuracy across training (p = 0.001). Compared to a 4.2% increase in sham participants, anodal tDCS over F10 increased performance by 20.6% (d = 1.71) and cathodal tDCS by 14.4% (d = 1.16). Conclusions These results provide further evidence for the capacity of tDCS applied to rVLPFC to enhance learning, showing a greater than quadrupling of test performance after training (491% of sham) in a difficult category learning task. Combined with our previous studies, these results suggest a generalized performance enhancement. Other tasks requiring sustained attention, insight and/or category learning may also benefit from this protocol.

9 pags., 7 figs., The conventional approach to perform two-qubit gate operations in trapped ions relies on exciting the ions on motional sidebands with laser light, which is an inherently slow process. One way to implement a fast entangling-gate protocol requires a suitable pulsed laser to increase the gate speed by orders of magnitude. However, the realization of such a fast entangling-gate operation presents a big technical challenge, as such the required laser source is not available off the shelf. For this, we engineer an ultrafast entangling-gate source based on a frequency comb. The source generates bursts of several hundred mode-locked pulses with pulse energy approximately 800 pJ at 5-GHz repetition rate at 393.3 nm and complies with all requirements for implementing a fast two-qubit gate operation. Using a single, chirped ultraviolet pulse, we demonstrate a rapid adiabatic passage in a Ca+ ion. To verify the applicability and projected performance of the laser system for inducing entangling gates we run simulations based on our source parameters. The gate time can be faster than a trap period with an error approaching 10-4., We acknowledge support from Project PGC2018- 094792-B-I00 (MCIU/AEI/FEDER,UE), CSIC Research Platform PTI-001, and CAM/FEDER Project No. S2018/ TCS-4342 (QUITEMAD-CM). Additionally, we acknowledge funding by the Institut für Quanteninformation GmbH.

Supracondylar fractures in the pediatric population are common. For years, K-wires have been the preferred method of surgical fixation. However, fixation with K-wires alone may lead to multiple complications. This study reports the results of surgical care of supracondylar humerus fractures using screw fixation with K-wires or screw fixation alone. This study retrospectively reviewed all patients with supracondylar humerus fractures treated with screw fixation between 2007 and 2013. Patients treated only with smooth wires, or having a displaced medial epicondyle, or presenting with lateral condyle fractures were excluded from the study. Flynn’s criteria were used to determine the outcome. Seventeen patients who met inclusion criteria formed the study group. All patients were followed until union, resolution of complications, and return to preinjury activity level. Satisfactory outcome was reported in 70.6% of patients with less than 15° loss of either flexion or extension. Mean time to union was 6.5 weeks (range 3.3–12.1 weeks). Screw fixation alone had a shorter mean time to union (5.5 weeks) than compared screw fixation with K-wires group (6.9 weeks). Full range of motion following surgical invention was associated with Flynn’s criteria (p value = 0.044). Screw fixation for pediatric supracondylar fractures is a viable option to achieve healing and early motion in highly unstable fractures as well as fractures which require (1) increased stability, (2) maintenance of stability during wound checks in the immediate postoperative period and after discontinuation of the cast, or (3) if further exploration like associated vascular injury is warranted.

Die hochauflosende optische Koharenztomographie (Spectral-Domain-OCT, SD-OCT) gilt als Goldstandard bezuglich Diagnose, Management und Verlaufskontrolle von Patienten mit vitreoretinalen Erkrankungen. Bei Patienten mit Glaskorperblutungen ist die praoperative Diagnostik zur Evaluation des intraokularen und retinalen Status limitiert, sodass die finale Therapieentscheidung lediglich wahrend der explorativen Vitrektomie getroffen werden kann. Wir berichten uber unsere Erfahrungen beim Einsatz der intraoperativen SD-OCT (iSD-OCT) wahrend explorativer Vitrektomie bei Patienten mit Glaskorperblutung. In Rahmen dieser Fallserie wurden 9 Patienten (11 Augen) mit Glaskorperblutungen untersucht. Praoperativ wurde der intraokulare Status mittels Sonographie erhoben. Im Anschluss erfolgte eine explorative 23G-Vitrektomie unter Visualisierung mit dem im Op.-Mikroskop (OPMI Lumera 700, Carl Zeiss Meditec, Jena, Deutschland) vollstandig integrierten iSD-OCT-Gerat (Rescan 700, Carl Zeiss Meditec, Jena, Deutschland). Die iSD-OCT ermoglichte bei allen Patienten zusatzlich zum intraoperativen En-Face-Mikroskopbild eine intraoperative Evaluation praretinaler, intraretinaler und subretinaler Strukturen in Echtzeit. Das operative Vorgehen – insbesondere die Notwendigkeit eines Peelings epiretinaler Membranen (ERM) bzw. der Membrana limitans interna (ILM), einer intravitrealen Medikamenteneingabe und die Wahl der geeigneten Tamponade – wurde anhand der iSD-OCT-Befunde festgelegt bzw. optimiert. Die iSD-OCT ist als zusatzliches diagnostisches Mittel bei Patienten mit Glaskorperblutungen sehr hilfreich. Es ermoglicht zusatzlich zum En-Face-Mikroskopbild eine intraoperative Echtzeitdiagnostik und erleichtert die Entscheidung der operativen Strategie.

Due to increased distribution of high-temperature processes in energy and process plants, more efficient and compact high-temperature heat exchangers are being developed. The additive manufacturing allows the construction of compact sizes and application-specific requirements. To evaluate the thermal performance of these heat exchangers, experimental investigations are evident. This study presents a test rig for testing compact high-temperature heat exchangers as well as a first set of thermal performance data of an additively manufactured plate-fin heat exchanger. The test rig can provide a maximum fluid temperature of 900°C and a maximum mass flow rate of 0.8 kg/min. A steam unit can add steam to the fluid stream to evaluate the influence of gas radiation on the thermal performance. The capabilities of this test rig are being tested with the plate-fin heat exchanger, varying the mass flow rate between 0.2 - 0.52 kg/min at a hot and cold inlet temperature of 750°C and 250°C. The overall effectiveness of the heat exchanger is approx. 0.9.

Background: Abnormal coagulation profiles were frequently observed in severe Covid-19 infected patients while Covid-19 vaccine-induced unusual thrombotic events and thrombocytopenia. A high incidence of developing platelet-activating antibodies has been detected in these patients. However, the mechanism of what triggers the bodies to produce these antibodies and what else contributes to the development of this abnormal coagulation have not yet been revealed. Aims: We provide a mechanism to describe the development of thrombotic thrombocytopenia in Covid-19 infected patients and after vaccination Methods: We used Dynamic light scattering (DLS), Quartz crystal microbalance (QCM), and Single-molecule force spectroscopy (SMFS) to prove that Covid-19-Spike glycoprotein (SP) cluster platelet factor 4 (PF4). The response of platelets to the resulting PF4/SP complexes was investigated in platelet aggregation tests and visualized by confocal laser scanning microscopy. Based on binding features of PF4 to Covid-19-SP and current reports, we proposed a novel mechanism describing factors that trigger the bodies to produce platelet-activating PF4-antibodies and cause abnormal coagulation. Results: We found that Covid-19-Spike glycoprotein (SP) cluster platelet factor 4 (PF4) and switched the surface zeta potential of PF4 from positive to negative values. The binding of Covid-19-SP to PF4 is as strong and stable as binding to PF4/Heparin complexes. Importantly, the resulting PF4/SP complexes induced platelet aggregation at a critical concentration ratio. We notice many similar binding features of PF4/Covid-19-SP complexes as compared with auto heparin-induced thrombocytopenia antibodies. Our findings allow us to i) propose a mechanism that describes the development of platelet-activating PF4-antibodies in Covid-19 infected and vaccinated patients and ii) explain the abnormal clotting disorder in patients. Conclusions: We concluded that not only platelet-activating antibodies but also PF4/Covid-19-SP complexes activate platelets. PF4 binds stably to the virus explain also the fact that causes a higher frequency of blood clots observed after AstraZeneca vaccination as compared with that of Pfizer-BioNTech Covid-19 vaccine.

Chondromyxoid fibroma-like osteosarcoma (CMF-OS) is a low-grade osteosarcoma, often misdiagnosed on initial biopsy as a benign lesion, with five cases previously described. We report a 13-year-old male with an intramedullary lytic CMF-OS of the right tibial proximal metaphysis with cortical destruction and soft tissue extension. Diagnosis was based on malignant new bone formation, increased mitotic figures, lamellar bone permeation with bony destruction, and correlation with imaging studies. There were no metastasis at presentation and the tumor showed good response to standard chemotherapy with >95% necrosis.

After the horrifying genocide in Rwanda in 1994, medical care of the small country almost broke down completely. During the following years, different medical fields had to be redeveloped. However, until 2009, there was no training program for otorhinolaryngology offered in Rwanda. Together with the University of Rwanda, we established a Master of Medicine Program that started in 2010. With the support of German otorhinolaryngologists, 10 ENT specialists have completed their training to date and 15 colleagues are currently still undergoing education in the program.

Jedes medizinische Fachgebiet unterliegt einem permanenten Wandel, so auch die HNO-Heilkunde. Anhand der Analyse der Trends gesellschaftlicher Veranderungen, des medizinischen Fortschritts und politscher Konsequenzen wird versucht, die Auswirkungen auf die HNO-Heilkunde partiell zu antizipieren. Der demographische Wandel und medizinische Fortschritt fuhren zu einem gesteigerten medizinischen Bedarf. Hinzu kommen die sog. Feminisierung der Medizin sowie veranderte Lebensentwurfe junger Arzte. Die Medizin entwickelt sich gegenwartig in Richtung einer individualisierten Therapie. Die Anzahl ambulanter Operationen wird zukunftig an Bedeutung zunehmen. Politisch wird die Digitalisierung der Medizin vorangetrieben. Ferner werden bestimmte vormals arztliche Leistungen an nichtarztliche Berufe delegiert. Die Verknappung der Ressource Arzt und der medizinische Fortschritt erfordern kunftig eine bessere Vernetzung zwischen den ambulanten und stationaren Bereichen. Praxisnetze und Praxis-Klinik-Kooperationen bieten ein bisher noch nicht ausreichend genutztes Potenzial einer kunftig verbesserten Zusammenarbeit zwischen den einzelnen Bereichen. Diese Entwicklung wird es jedoch nicht zum Nulltarif geben. Die HNO-Heilkunde wird sich unter dem Einfluss der beschriebenen Faktoren zu einem schwerpunktmasig ambulant operativ-konservativen Fach wandeln. Eingebettet in dezentrale Netzwerke und Kooperationen werden Arztinnen und Arzte kunftig unterstutzt von IT-Anwendungen und spezialisierten nichtarztlichen Berufen dauerhaft sowohl in Klinik als auch Praxis arbeiten. Dieses setzt die vorherige Klarung der Finanzierungsfragen voraus.

Sleep is critically important to consolidate information learned throughout the day. Slow-wave sleep (SWS) serves to consolidate declarative memories, a process previously modulated with open-loop non-invasive electrical stimulation, though not always effectively. These failures to replicate could be explained by the fact that stimulation has only been performed in open-loop, as opposed to closed-loop where phase and frequency of the endogenous slow-wave oscillations (SWOs) are matched for optimal timing. The current study investigated the effects of closed-loop transcranial Alternating Current Stimulation (tACS) targeting SWOs during sleep on memory consolidation. 21 participants took part in a three-night, counterbalanced, randomized, single-blind, within-subjects study, investigating performance changes (correct rate and F1 score) on images in a target detection task over 24 h. During sleep, 1.5 mA closed-loop tACS was delivered in phase over electrodes at F3 and F4 and 180° out of phase over electrodes at bilateral mastoids at the frequency (range 0.5–1.2 Hz) and phase of ongoing SWOs for a duration of 5 cycles in each discrete event throughout the night. Data were analyzed in a repeated measures ANOVA framework, and results show that verum stimulation improved post-sleep performance specifically on generalized versions of images used in training at both morning and afternoon tests compared to sham, suggesting the facilitation of schematization of information, but not of rote, veridical recall. We also found a surprising inverted U-shaped dose effect of sleep tACS, which is interpreted in terms of tACS-induced faciliatory and subsequent refractory dynamics of SWO power in scalp EEG. This is the first study showing a selective modulation of long-term memory generalization using a novel closed-loop tACS approach, which holds great potential for both healthy and neuropsychiatric populations.

Endocrine disorders are the most common causes of secondary hypertension. Early diagnosis and specific treatment are crucial for improvement of the prognosis. This article provides an overview on which clinical constellations point to an increased risk of secondary causes of hypertension. These include spontaneous hypokalemia, young age at onset of hypertension, adrenal incidentaloma and therapy refractive arterial hypertension. The basic diagnostics include determination of the aldosterone to renin ratio, measurement of free plasma metanephrines and a 1 mg dexamethasone suppression test. Borderline results require repeated control testing and/or confirmatory testing under standardized test conditions. In cases of repeatedly conspicuous results referral to a specialized clinic should be considered for further clarification and confirmation of the diagnosis. Imaging diagnostics may constitute an adjunct to laboratory testing after the diagnosis has been confirmed. Therapeutic algorithms vary depending on the underlying endocrine disease.

High-resolution spectral domain optical coherence tomography (SD-OCT) is a gold standard technique for diagnosis, management and monitoring of patients with vitreoretinal diseases. Preoperative diagnostics for evaluation of intraocular and retinal status in patients with vitreous haemorrhage are limited, thus final therapeutic decisions can only be made during explorative vitrectomy. We evaluated the use of intraoperative SD-OCT (iSD-OCT) as a real-time additional diagnostic tool during explorative vitrectomy in patients with vitreous haemorrhage.We report on 9 patients (11 eyes) with vitreous haemorrhage. Preoperative ultrasound was performed to evaluate intraocular status. Subsequently, an explorative 23G pars plana vitrectomy was performed under visualisation with the OPMI Lumera 700 surgical microscope (Carl Zeiss Meditec, Jena, Germany) equipped with a fully integrated iSD-OCT device (Rescan 700, Carl Zeiss Meditec, Jena, Germany) as a real-time diagnostic tool.In all patients, intraoperative iSD-OCT allowed real-time evaluation of the preretinal, intraretinal and subretinal structures in addition to the intraoperative en face image. The further surgical strategy, i. e. necessity for peeling of epiretinal membranes (ERM) or of the inner limiting membrane (ILM), application of intravitreal medication and selection of the appropriate tamponade, was based on and optimised according to the iSD-OCT images.Intraoperative iSD-OCT is highly useful as an additional intraoperative diagnostic tool in patients with vitreous haemorrhage. In addition to the en face microscope image, it facilitates intraoperative real-time diagnosis and aids therapeutic decision-making during surgery.

Introduction Premature growth arrest can pose a challenge to the orthopedic surgeon. Various options for treating physeal arrest exist. Methods Systematic searches were conducted on PubMed/Medline, ScienceDirect, OVID, and Cochrane Library. Secondary searching was performed, where certain articles from reference lists of the selected studies were reviewed that were not found in the primary search. Results This review article discusses the different methods of management for premature growth arrest. Conclusions The use of mesenchymal stem cells provides a promising alternative treatment modality.

Chemical vapour deposition (CVD) diamond coated tools have demonstrated their potential for the machining of difficult to machine materials in the last 10 years. The lack of adequate coating adhesion in many cases remains an issue and often leads to spontaneous coating delamination and sudden tool failure however. The work described in this paper was undertaken with the aim of understanding the influence of residual stresses and coating quality on the coating adhesion during the machining of aluminium alloys. Residual stresses were determined using Raman spectroscopy as well as X-ray diffraction analysis and a comparison of the results obtained using the two methods is given. Raman spectroscopy was also implemented to analyse the coating quality. Furthermore, the failure mechanism of CVD diamond coated tools was studied using cross-sections prepared by focused ion beam sputtering.

All medical specialties are changing permanently, including otorhinolaryngology. Analyzing trends in social changes, medical progress, and political decisions will allow the effects of these on ENT medicine to be at least partially anticipated.Demographic changes and medical progress lead to an increasing demand for medical treatments. In addition, increasing numbers of female physicians are observed, as are many changes in the lifestyles of young physicians. Medical treatment will develop toward more individualized therapies in the future. ENT surgery will become a more ambulatory medical specialty. Driven by political decisions, digital medicine will become more important. Particular services once provided by physicians will be delegated to non-physician professionals.The lack of physicians and the progress in medicine require better networking between in- and outpatient services in the future. The potential of such collaborations is currently not completely realized. However, these developments will also increase the cost of health care.These trends will develop otorhinolaryngology into a conservative and surgical ambulatory care driven medical specialty. Embedded in decentralized networks and cooperations, and supported by IT technologies and specialized non-physician professionals, ENT physicians will work in hospitals as well as in practices on a permanent basis. Nevertheless, the question of funding these changes has yet to be clarified.

A central goal of molecular simulations is to predict physical or chemical properties such that costly and elaborate experiments can be minimized. The reliable generation of molecular models is a critical issue to do so. Hence, striving for semiautomated and fully automated parameterization of entire force fields for molecular simulations, the authors developed several modular program packages in recent years. The programs run with limited user interactions and can be executed in parallel on modern computer clusters. Various interlinked resolutions of molecular modeling are addressed: For intramolecular interactions, a force-field optimization package named Wolf2Pack has been developed that transfers knowledge gained from quantum mechanics to Newtonian-based molecular models. For intermolecular interactions, especially Lennard–Jones parameters, a modular optimization toolkit of programs and scripts has been created combining global and local optimization algorithms. Global optimization is performed by a tool named CoSMoS, while local optimization is done by the gradient-based optimization workflow named GROW or by a derivative-free method called SpaGrOW. The overall goal of all program packages is to realize an easy, efficient, and user-friendly development of reliable force-field parameters in a reasonable time. The various tools are needed and interlinked since different stages of the optimization process demand different courses of action. In this paper, the conception of all programs involved is presented and how they communicate with each other.

Mit sprachaudiometrischen Untersuchungen lassen sich keine strukturierten Aussagen des Patienten hinsichtlich eines tatsachlichen Nutzens einer Horgerateversorgung aus seinem individuellen Erleben heraus erhalten. Diese Lucke wird durch die Anwendung von Frageninventaren geschlossen. Der APHAB (Abbreviated Profile of Hearing Aid Benefit, deutsche Version) ist ein evaluiertes Inventar, das anhand von je 6 Fragen zu vier verschiedenen Horsituationen die speziellen Probleme eines Schwerhorigen ohne und mit Horgeraten (HG) ermittelt. 560 Patienten wurden vor und nach einer Horgerateversorgung mittels APHAB zu ihrem Horvermogen befragt. Zudem wurden noch Angaben zu bisherigen Erfahrungen mit HG, der taglichen Verwendungsdauer und dem Grad der Schwerhorigkeit erfasst. Das Durchschnittsalter der Patienten lag bei knapp 70 Jahren, 84% der Patienten erhielten zum ersten Mal ein HG im Leben, 83% wiesen eine mittel- bis hochgradige Schwerhorigkeit auf. Die APHAB-Ergebnisse der Befragung wurden in Perzentil- und Kontingenztabellen aufbereitet; in Letzterer lassen sich bedingte Wahrscheinlichkeiten fur den potenziellen Nutzen eines HG unter Kenntnis der Antworten eines Patienten ohne HG fur jede APHAB-Skala ableiten. Der APHAB kann regelmasig im Rahmen einer HG-Versorgung zur Beurteilung des Nutzens von HG und zum Erkennen von besonders problematischen Horsituationen eines Patienten eingesetzt werden. Er erganzt die bisher gebrauchlichen Methoden, insbesondere den Freiburger Sprachtest, um Angaben aus der Sicht des Patienten, sodass die Qualitat von Diagnostik und Therapie fur den schwerhorigen Patienten verbessert, der Erfolg einer HG-Versorgung qualitativ erfasst und besondere Problembereiche vorhergesagt und damit die Anzahl ungenutzter Horgerate moglicherweise reduziert werden konnen.

Fur symptomlose, risikobehaftete Patienten gibt es kein etabliertes Fruherkennungsprogramm zur Entdeckung von Kopf-Hals-Karzinomen im Sinne einer Sekundarpravention. Eine solche erscheint umso wunschenswerter, weil die Heilungsaussichten und die Lebensqualitat stark vom Tumorstadium zum Zeitpunkt der Erstdiagnose abhangen. 370 symptomlose Patienten, die u. a. mindestens einen der Risikofaktoren „Rauchen“, „Alkoholkonsum“, „Reflux“ aufwiesen, wurden einmal innerhalb eines Jahres mittels Lupenmikroskopie und Endoskopie hinsichtlich auffalliger Befunde im oberen Aerodigestivtrakt untersucht. Von den 370 Patienten wurden bei 13 Patienten (3,5%) Gewebeproben entnommen. Acht Patienten (2,2%) wiesen ein Plattenepithelkarzinom auf. Ein weiterer Patient litt an einem Non-Hodgkin-Lymphom. Mit den beschriebenen Methoden lassen sich Risikopatienten einfach und sicher untersuchen. Die Quote der gefunden Malignome ubersteigt nach bisherigen Publikationen die zu erwartende Rate deutlich, was vermutlich an der gezielten Untersuchung von Risikopatienten liegt.