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T1 glottic cancer is a highly treatable disease with local control (LC) rates over 90% by either primary radiotherapy (pRT) or transoral laser microsurgery (TLM). LC of T2 glottic cancers is 15 percent points poorer on average. However, salvage after pRT entails more than 50% total laryngectomy. Therefore, there is a need for enhanced LC. Altered fractionation regimens improved LC in T1 but not in T2. For this reason, for T2, alternative strategies must be considered. In a large observational cohort study including 531 early-stage laryngeal cancers, a small number of patients were treated with primary chemoradiotherapy (pCRT). In multivariable analysis, factors associated with significantly poorer outcomes included age, comorbidities, supraglottic localization, and T category. While there was a significant difference between pRT and surgery (HR 1.79, 95%-CI: 1.15–2.79), there was none between pCRT and surgery (HR 0.70, 95%-CI: 0.33–1.51). There is evidence from the literature that pCRT in early glottic cancers could yield results that surpass the limits so far experienced in radiotherapy alone with acceptable toxicity. Thus, prospective randomized studies with larger numbers of patients are warranted.

Im Rahmen des BMVI-Expertennetzwerks Themenfeld 1 „Verkehrs- und Infrastruktur an Klimawandel und extreme Wetterereignisse anpassen“ untersucht die Bundesanstalt für Wasserbau Hamburg u.a. die Bedeutung von Meeresspiegelanstieg und Topographieänderungen in der Deutschen Bucht und ihren Ästuaren. Der Meeresspiegelanstieg beeinflusst die Hydrodynamik in den Ästuaren und somit sowohl mittlere Tiden, als auch Sturmflutereignisse. Da das Küstenprofil in einem morphodynamischen Gleichgewicht mit den hydrodynamischen Kräften steht, kann sich jedoch auch die Topographie eines Küstengebietes durch den Meeresspiegelanstieg verändern. Die Wattflächen der Deutschen Bucht, welche eine wichtige Komponente des Küstenschutzes sind, können, bei ausreichender Sedimentverfügbarkeit, zu einem gewissen Anteil mit dem Meeresspiegelanstieg mitwachsen. Der Einsatz hydrodynamisch-numerischer Modelle ermöglicht es, den Einfluss der genannten Prozesse auf z. B. Sturmflutscheitelwasserstände einzeln zu untersuchen. In einer Sensitivitätsstudie analysieren wir den Einfluss eines Meeresspiegelanstiegs und einer topographischen Erhöhung der Wattflächen auf Sturmflutereignisse in der Tideelbe. Die Ergebnisse zeigen, dass der Sturmflutscheitelwasserstand (HW) in der Tideelbe etwas höher ansteigt als der am Modellrand eingesteuerte Meeresspiegelanstieg. Eine Erhöhung der Wattflächen führt zu einem Absinken des HW gegenüber einem Szenario mit alleinigem Meeresspiegelanstieg ohne Topographieänderung. Die Berechnung weiterer Analysegrößen, wie der Durchflussfläche, ermöglicht ein besseres Systemverständnis der untersuchten Änderungen in der Tideelbe. Die Untersuchungen verdeutlichen die positiven Auswirkungen eines Wattwachstums bei Meeresspiegelanstieg auf den Küstenschutz und die Notwendigkeit, einem Verlust an Wattflächen durch den Klimawandel entgegenzuwirken.

Future mean sea level rise will influence tidal dynamics and storm surge events in estuaries. The bathymetry in estuaries and coastal areas will also be affected by mean sea level rise, since it is in a morphodynamic equilibrium with hydrodynamic forces. Tidal flats, which are an important component of coastal protection, will grow to a certain extent with mean sea level rise in case of sufficient sediment availability.With the help of a highly resolved hydrodynamic-numerical model of the German Bight (North Sea), we analyse the potential influence of mean sea level rise and vertical growth of tidal flats on tidal dynamics and storm surge events in the Elbe estuary.The results show an increase of tidal amplitude and storm surge water levels due to mean sea level rise. A bathymetric rise of tidal flats in the German Bight and the mouth of the Elbe estuary leads to a decrease in storm surge water level and tidal amplitude compared to the scenario with sole mean sea level rise without a change in bathymetry. Further analyses show, how geometric parameters of the Elbe estuary are changing due to mean sea level rise and tidal flat growth. These changes in geometry influence tidal dynamics and can therefore be an explanation for the observed changes in tidal amplitude and storm surge water levels.These findings enable a better understanding of future changes in the Elbe estuary and support coastal managers in decision making processes concerning adaptation options to reduce the impacts of climate change.

Storm tides are a major hazard for the German North Sea coasts. For coastal protection and economic activities, planning information on the probability and magnitude of extreme storm tides and their possible future changes is important. This study focuses on the most extreme events and examines whether they could have become more severe under slightly different conditions while still remaining within physical plausibility. In the face of a limited number of observational data on very severe events, an extensive set of model data is used to extract most extreme storm tide events for locations in the German Bight, in particular Borkum and the Ems estuary. The data set includes water levels and respective atmospheric conditions from a hindcast and future climate realizations without sea level rise describing today's and possible future conditions. A number of very severe events with water levels exceeding those measured near Borkum since 1906 are identified in the data set. A possible further amplification of the highest events is investigated by simulating these events for the North Sea with different phase lags between the astronomical tide given at the open model boundaries and the wind forcing. It is found that superposition of spring tide conditions, different timing of the astronomical high water and atmospheric conditions during the highest storm event would cause an enhancement of the highest water level up to about 50 cm. The water levels of the two highest events from the data set are used to analyse the effects in the Ems estuary using a high-resolution model of the German Bight. Additionally, the influences of an extreme river runoff and of sea level rise are studied. The extreme river runoff of 1200 m3 s−1 increases the highest water levels by several decimetres in the narrow upstream part of the Ems estuary. This effect diminishes downstream. The sea level rise increases the water level in the downstream part of the Ems estuary by the amount applied at the model boundary to the North Sea. In the upstream part, its influence on the water level decreases. This study may serve as a first step towards an impact assessment for severe storm tides and towards implications for coastal zone management in times of climate change.

Storm tides are an essential hazard for the German North Sea coasts. For coastal protection and economic activities, planning information on probability and magnitude of extreme storm tides and their possible future changes is important. This study focuses on the most extreme events and examines whether they could have become more severe under slightly different conditions still remaining within the physical plausibility. In the face of limited amount of observational data on very severe events, an extensive set of model data is used to extract most extreme storm tide events for locations in the German Bight, in particular Borkum and the Ems estuary. The data set includes water levels and respective atmospheric conditions from a hindcast and future climate realizations without sea level rise describing today's and possible future conditions. A number of very severe events with water levels exceeding those measured near Borkum since 1906 has been identified in the data set. A possible further amplification of the highest events is investigated by simulating these events for the North Sea with different phase lags between the astronomical tide given at the open model boundaries and the wind forcing. It was found that superposition of spring tide conditions, different timing of the astronomical high water and atmospheric conditions during the highest storm event would cause an enhancement of the highest water level up to about 50 cm. The amplified water levels of the two highest events from the data set are used to analyse the effects in the Ems estuary using a high-resolution model of the German Bight. Additionally, the influence of an extreme river runoff and of sea level rise is studied. The extreme river runoff of 1200 m3 s−1 increases the highest water levels by several decimeters in the narrow upstream part of the Ems estuary. This effect diminishes downstream. The sea level rise increases the water level in the downstream part of the Ems estuary by the amount applied at the model boundary to the North Sea. In the upstream part, its influence on the water level decreases. This study may serve as a first step towards an impact assessment for severe storm tides and their implications for coastal areas and activities.

Assessment of caffeine intake as part of the risk assessment of caffeine in adolescents and young adults aged 14–39 years from foods, beverages and drugs, and to identify the main contributors to caffeine intake. Assessment of caffeine intake by a validated semiquantitative food frequency questionnaire including all caffeine-containing foods and beverages based on laboratory analysis of caffeine content and caffeine-containing drugs in a cross-sectional study design in a sample of 700 subjects (353 men and 347 women) designed to be representative for the Austrian population in respect to an age of 14–39 years and sex. The caffeine intake of the total sample on average was 357±400 mg per day (5.3±6.0 mg/kg body weight (bw) per day) with a median intake of 259 mg per day (3.7 mg/kg bw per day) and intakes at the 95th percentile of 957 mg per day (14.5 mg/kg bw per day). Major contributors to caffeine intake were coffee (60.8%), energy drinks (11.9%) and colas (9.5%). Caffeine intake based on kilogram bw was significantly higher for subjects aged 26–39 years compared with subjects aged 14–17 years and 18–25 years (P=0.012). The highest potential for the reduction in caffeine intake is by reducing coffee consumption; the elimination of any other caffeine source would not result in substantial decreases in caffeine intake.

Survival in patients with laryngeal cancer has not increased remarkably within the last years. It is presumed that a variety of factors act jointly in predicting survival after diagnosis: tumour stage, tumour site, treatment approaches, age and comorbidities. The aim of this German clinical multi-centre study is to present results from multivariate analysis. A retrospective cohort study was conducted in four hospitals in South-West Germany. Incident cases with laryngeal squamous cell carcinoma were included for the years 1998 to 2004, resulting in a population sample of 594 patients. Multivariate regression analysis was performed using the Cox proportional hazards model. Patients were followed up for 64.1months on average. Overall 5-year survival was 66% (95% confidence interval (CI): 62-70%). The strongest risk factors in multivariate analysis were age at first diagnosis (hazard ratio (HR): 1.5; 95% CI: 1.5-1.7 per each additional 10years), tumour stage, and the development of recurrences (HR 3.1; 95% CI: 2.3-4.2) or second primary carcinomas (HR 2.1; 95% CI: 1.4-3.1). A somewhat weaker effect was shown for patients with comorbidities (using Charlson's comorbidity index). The choice of treatment did not strongly affect survival when adjusting for other factors, possibly because the optimal treatment approach was applied for the specific constitution and requirements of each patient. For future research it would be desirable to study the effect of treatment on quality of life in multivariate analysis as well as other modifiable risk factors as smoking and drinking reduction or cessation after diagnosis.

Laryngeal cancer is the second most common cancer of the respiratory tract with a relative 5-year survival over all tumour sites in the USA (61.6%; SEER 2009), which is much better than other head and neck cancers. The aim of this paper is to review and summarise data on the survival of laryngeal cancer patients. Literature search was conducted to identify articles in PubMed up to June 2009. Thirty studies with different study aims including sufficient information on survival of laryngeal cancer patients were identified. The 5-year overall survival ranged from 0 to 100%, depending on the T- and N-category, therapeutic approach and tumour location. The involvement of other factors such as genetics, nutrition and lifestyle habits remains uncertain. Our meta-analysis on a subgroup of published studies yielded an overall 5-year relative survival rate of 64.2% (95% confidence interval 63.7-64.7%). Different study aims and patient selection criteria prohibit general conclusions. However, this review may provide an actual picture of the complexity of factors influencing the survival of laryngeal cancer patients.

A method for accurate on-line ultra-trace analysis of palladium by inductively coupled plasma mass spectrometry has been developed. After separation of interfering cations by cation exchange chromatography, palladium was selectively adsorbed on to a C18 micro-column on-line which had been reversibly loaded with the complexing agent N,N-diethyl-N′-benzoylthiourea (DEBT). The palladium complex formed was eluted with methanol and introduced into an ICP-SFMS via microconcentric nebulization with membrane desolvation. Quantification of palladium was carried out by isotope dilution analysis. The results obtained via the isotope ratios of 105Pd/108Pd and 106Pd/108Pd agreed within their measurement uncertainty. For solid samples (total intake 100 mg, final sample volume of 10 mL after closed vessel microwave digestion) the limit of detection was 0.24 ng g−1 palladium (2 mL of digested sample). The necessity of combining matrix separation and pre-concentration for elimination of spectral interferences was demonstrated using soil samples. The method was validated by analysis of the certified reference material BCR-723 (road dust).

Background levels of platinum were determined in human autopsy tissues taken from five individuals. The investigated specimens were lung, liver and kidney. Sample preparation involved microwave digestion followed by an open vessel treatment. Inductively-coupled plasma sector field mass spectrometry (ICP-SFMS) was applied in combination with an ultrasonic nebulization/membrane desolvation system for sample introduction. Isotope dilution analysis was employed for accurate quantification of platinum. Excellent procedural detection limits (3 s validation) of 20, 20 and 34 pg g(-1) dry weight were obtained for lung, liver and kidney tissue, respectively. Due to the lack of appropriate biological reference material, road dust (BCR-723) was used for method validation. Platinum levels ranging between 0.03 and 1.42 ng g(-1) were determined in the investigated samples. The platinum concentrations observed in human lung tissue may reflect the increasing atmospheric background levels of platinum originating from car catalysts. The presence of platinum in kidney and liver tissue samples clearly indicates the bioavailability of the element.

Storms over the North Sea can cause storm surges in the the German Bight that reach into the Ems, Jade-Weser and Elbe estuaries. The effect in each estuary can vary due to the different hydrographical structure, bathymetry, location in the the German Bight, exposure to wind direction and fresh-water discharge. A coupled meteorological and hydrodynamical numerical model was used to investigate the relative importance of these effects. With this model the impact of variations in wind speed and direction, in topography, or in fresh-water discharge can be investigated separately or in combination for historical or artificial storm surges. A better insight into the storm surge ‘sensitivity’ of the individual estuaries is obtained.

A method for on-line pre-concentration of platinum with subsequent determination by electro-thermal atomic absorption spectrometry (ETAAS) has been developed. After a preliminary treatment of the sample solution with tin(II)-chloride the formed anionic Pt–Sn complexes were on-line adsorbed on a C18 micro column which has been reversibly loaded with the chelating agent N,N-diethyl-N′-benzoylthiourea. The formed platinum complex was eluted with ethanol and directly introduced into the graphite furnace. Using a sample volume of 1.57 mL the limit of detection was calculated to be 0.1 μg L−1. The reproducibility of the method given as the relative standard deviation was 5.5% at a concentration level of 0.5 μg L−1 Pt (n = 10). The accuracy of the developed method has been demonstrated by the analysis of the certified reference material BCR-723 (road dust). The new method has been applied to the analysis of platinum in aerosol samples collected in a highway-tunnel in Vienna, Austria.