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Vorgeschichte: 60-jähriger männlicher Patient wird aus externem Haus übernommen mit progredienter Dyspnoe, deutlichen Ödemen der Extremitäten sowie unklarer Polyserositis mit rez. Pleura- und Perikardergüssen die mehrfach punktiert worden waren. Vorerkrankungen: 1-Gefäß-KHK,[zum vollständigen Text gelangen Sie über die oben angegebene URL], Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

In 1993, J.Y. Chevalier described a single needle venovenous extracorporeal membrane oxygenation (ECMO) system using a nonocclusive roller pump and alternating clamps for pulmonary support in neonates. We modified this system to use it in older children as well and for additional indications. Introducing a double raceway and 2 different sizes of tubing sets and performing percutaneous approach, we treated 21 children (age 1 day to 49 months) using this system. Indications for treatment were hypoxia and hypoxic induced myocardial dysfunction resulting from pulmonary failure, sepsis, and congenital defects. Of the chiIdren treated for neonatal indications. 7/9 survived. For 2 children ECMO was terminated because of intraventricular hemorrhage (TVH). In the pediatric group 5/7 of the children could be weaned from ECMO, and 2 children died after more than 30 days on ECMO. Two of the children who had been almost completely weaned died later because of therapy withdrawal following a brain death diagnosis. In the cardiac group, 3/5 of the children survived. We conclude that the described system is an effective venovenous ECMO system that reduces invasivity and expenditure.

Objective: The newly proposed oxygen reactivity index (ORX) has been shown to be linked to neurological outcome after traumatic brain injury and subarachnoid haemorrhage. Currently, the main debate focuses on whether ORX correlates with the established pressure reactivity index (PRX). Furthermore, there[for full text, please go to the a.m. URL], 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

An oxygen barrier coating has been developed, which is effective in preventing oxidation and oxygen embrittlement of Ti and several low-Al content Ti-base alloys during exposure to oxidizing environments at elevated temperatures. The fabrication process has involved magnetron co-sputtering of titanium and aluminum followed by vacuum annealing and plasma immersion ion implantation of fluorine. The resulting coating consists primarily of γ-TiAl while containing a minor portion of Ti3Al present in the coating/substrate interfacial region. The implantation of fluorine provides the necessary conditions for triggering the halogen effect upon subsequent high-temperature exposure in air. Systematic characterization of the coating material in terms of microstructure, phase formation and element depth distribution has been performed using cross-sectional transmission electron microscopy (XTEM) in conjunction with electron energy loss spectroscopy (EELS), energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), and elastic recoil detection (ERD). Overall, the coating fabrication process has been found to be independent of the substrate material making the technique universally applicable at least to the alloys studied. Following oxidation in air at 600°C for 100 h, specimens have been prepared for metallographic analysis, and their cross sections have been characterized by scanning electron microscopy (SEM) in combination with EDX, and electron probe microanalysis (EPMA). The results obtained show that during oxidation exposure the γ-TiAl coating is capable of forming a protective alumina-containing scale, which serves as an oxygen barrier, thereby preventing oxygen embrittlement in the substrate material. In addition, since the only constituents of the coating are Ti and Al, it exhibits excellent chemical substrate compatibility.

We study the metal-insulator transition in two sets of amorphous Sil-x Nix films. The sets were prepared by different, electron-beam-evaporation- based technologies: evaporation of the alloy, and gradient deposition from separate Ni and Si crucibles. The characterization included electron and scanning tunneling microscopy, glow discharge optical emission spectroscopy, energy dispersive x-ray analysis, and Rutherford back scattering. Investigating the logarithmic temperature derivative of the conductivity, w = d ln s / d ln T, we observe that, for insulating samples, w(T) shows a minimum, increasing at both low and high T. Both the minimum value of w and the corresponding temperature seem to tend to zero as the transition is approached. The analysis of this feature of w (T,x) leads to the conclusion that the transition in Si 1-xNix is very likely discontinuous at zero temperature in agreement with Mott's original views.

We evaluated a bedside method of assessing respiratory compliance from chest expansion, which is judged by eye and classified into three tidal volume categories, and from the inflation pressure read on the respirator's manometer. Compliance assessed by this method was compared with the compliance measured by the injection technique in 45 randomly chosen newborns ventilated for various diseases. The compliance assessed from chest expansion and inflation pressure correlated significantly with the measured compliance (r = 0.86, p < 0.001). Interobserver reliability was acceptable for clinical practice and improved within 6 months of training (weighted kappa = 0.67 versus 0.86). Within ten individuals, changes of compliance assessed by this method were also significantly correlated with those of measured compliance (r = 0.85, p < 0.01). This method, termed "optical compliance," is instantaneously and always available for all patients on ventilators without any additional apparatus and thus might improve the assessment of respiratory function in routine care and emergency situations.