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A 15-year-old girl was brought to the emergency department of a hospital by ambulance with extensive facial trauma following a horse's kick. The considerable impact resulted in a combination of injuries to the bone, teeth and soft tissue. Following the transfer from the ambulance, the AE physician immediately consulted an oral and maxillofacial surgeon. Consequently, the patient could be brought to the operating theatre almost straight after stabilisation. There, the oral and maxillofacial surgeon first repositioned her teeth in anatomical position, followed by repositioning and fixation of the mandibular fracture. Next, the teeth in the upper front were stabilised with an acid-etch composite splint and the lip was reconstructed.Een 15-jarig meisje werd met een ambulance naar een spoedeisende hulppost gebracht vanwege uitgebreid aangezichtsletsel na een trap van een paard. Er was sprake van een combinatie van bot-, dentaal en wekedelenletsel. De spoedeisendehulparts had na de overdracht van de ambulance direct een mka-chirurg geconsulteerd. Hierdoor kon na stabilisatie en onderzoek de patiënt vrijwel direct door naar de operatiekamer. Daar reponeerde de mka-chirurg eerst haar tanden in anatomische stand, gevolgd door repositie en fixatie van de mandibulafractuur. Aansluitend werden de gebitselementen in bovenfront gestabiliseerd met een composietetsspalk en de lip gereconstrueerd.

While microalgae hold the promise for conversion of sunlight and CO 2 to a wide variety of products, the economics of algae processes are still debatable. We have designed an open thin-layer cascade photobioreactor for high-cell density cultivation of saline microalgae to advance economic microalgae mass production. Pilot-scale reactors with a surface area of up to 8 m 2 (cultivation volume 50–140 L) were constructed and evaluated using a dynamic climate simulation technology (light, air temperature and humidity) integrating natural sunlight and multi-color LED arrays for a highly realistic reproduction of the sunlight spectrum. Batch processes with Nannochloropsis salina were performed in these reactors in the physically simulated Mediterranean summer climate of Almeria, Spain – an ideal location for outdoor microalgae cultivation. Two reactor variants were examined: one with a smooth but expensive rigid channel made of polyethylene sheets, and one with a more uneven but significantly less expensive channel made of pond liner. Maximal intra-day growth rates of 1.9 d −1 were observed at a cell density of 1–3 g L −1 . The maximal cell density of 50 g L −1 was obtained within 25 days. These high growth rates and cell densities markedly exceed literature data. No difference in growth between the channel variants was observed. This suggests that cost-efficient large-scale thin-layer cascade reactors with inexpensive pond liner channels are feasible. The high cell density allows a reduction of harvesting cost. Optimal process conditions were identified by analyzing the batch and daily economic bioprocess metrics: At a cell density of 17 g L −1 , an areal biomass productivity of 25 g m −2 d −1 (volumetric productivity 4 g L −1 d −1 ) and a photosynthetic conversion efficiency of 4.6% were observed. The reactor design is discussed in detail to encourage further advancement of thin-layer algal cultivation technology.

Presentation of primary malignant melanoma of the vagina. Summary of clinical findings and management.Case report.Nemocnice Pardubického kraje a.s., Porodnicko-gynekologická klinika, Pardubice.We report a case of primary malignat melanoma in a 44 year old woman, with symptoms of abnormal vaginal bleeding and painful intercourse.Primary malignant melanoma of the vagina is rare disease. Goal of therapy is complete removal of primary tumor.

Suburethral tension-free vaginal tape is used for the treatment of stress urinary incontinence with a high success rate. Often patients report having stress incontinence, as well as co-existing micturition problems which are attributable to overactive bladder syndrome (OAB). The present study examines the effect of suburethral tape on the symptoms of OAB. In the study, we used the transobturator vaginal tape inside-out technique (TVT-O). Materials and Methods: 53 patients were included in the study, all had proven urodynamic stress incontinence and symptoms of overactive bladder. The patients were examined preoperatively and 3 months after the TVT-O placement. Results: The individual OAB symptoms improved significantly, with urinary frequency and urge incontinence improving more than nocturia. The frequency of micturition decreased on average from 16.1 to 10.1 episodes/24 hours, while nocturnal frequency of micturition decreased from 2.2 to 1.1. Not a single patient experienced the simultaneous worsening of all three measured variables, however 19 % of patients did report their simultaneous disappearance. Their quality of life that had been affected by OAB was measured on the basis of validated questionnaires, and found to have improved significantly. Only 28 % of patients reported a desire for drug treatment of OAB symptoms following tape placement. Conclusions: TVT-O placement leads to a significant improvement of the symptoms of overactive bladder syndrome. Patient quality of life – which was affected by OAB – was also enhanced by the tape placement. This accounts for a substantial share of the overall success of the suburethral tape.

This work presents the possibilities offered by a blind source separation method such Multivariate Curve Resolution‐ Alternating Least Squares (MCR‐ALS) in the analysis of Ion Mobility Spectra (IMS). Two security applications are analyzed in this context: the detection of TNT both in synthetic and real samples. Results obtained show the possibilities offered by the direct analysis of the drift time spectra when an appropriate resolution method is used.

In surface ionization (SI) gas detection adsorbed analyte molecules are converted into ionic species at a heated solid surface and extracted into free space by an oppositely biased counter electrode. In the present work we consider the formation of positive and negative analyte gas ions at SnO2 surfaces. We find that SI leads to positive ion formation only, with the SI efficiency scaling with the ionization energy of the analyte gas molecules. Aromatic and aliphatic hydrocarbons with amine functional groups exhibit particularly high SI efficiencies.

IMS is a well know technology within the range of security based applications. Its main advantages lie in the simplicity of measurement, along with a fast and sensitive detection method. Contemporary technology often fails due to interference substances, in conjunction with saturation effects and a low dynamic detection range. High throughput facilities, such as airports, require the analysis of many samples at low detection limits within a very short timeframe. High detection reliability is a requirement for safe and secure operation. In our present work we developed a laser based ion‐mobility‐sensor which shows several advantages over known IMS sensor technology. The goal of our research was to increase the sensitivity compared to the range of 63Ni based instruments. This was achieved with an optimised geometric drift tube design and a pulsed UV laser system at an efficient intensity. In this intensity range multi‐photon ionisation is possible, which leads to higher selectivity in the ion‐formation proc...

Several studies have compared bone marrow (BM) and peripheral blood (PB) as stem cell sources in patients receiving allografts, but the cell doses infused have not been considered, especially for BM. Using the ALWP/EBMT registry, we retrospectively studied 881 adult patients with acute myelocytic leukemia (AML), who received a non-T-depleted allogeneic BM (n = 515) or mobilized PB (n = 366) standard transplant, in first remission (CR1), from an HLA-identical sibling, over a 5-year period from January 1994. The BM cell dose ranged from 0.17 to 29 × 108/kg with a median of 2.7 × 108/kg. The PB cell dose ranged from 0.02 to 77 × 10 8/kg with a median of 9.3 × 108/kg. The median dose for patients receiving BM (2.7 × 108/kg) gave the greatest discrimination. In multivariate analyses, high-dose BM compared to PB was associated with lower transplant-related mortality (RR = 0.61; 95% CI, 0.39-0.98; P = .04), better leukemia-free survival (RR = 0.65; 95% CI, 0.46-0.91; P = .013), and better overall survival (RR = 0.64; 95% CI, 0.44-0. 92; P = .016). The present study in patients with AML receiving allografts in first remission indicates a better outcome with BM as compared to PB, when the dose of BM infused is rich. © 2003 by The American Society of Hematology.

Under the German social security system, medical benefits and services fall under the health insurance system, while vocational ones are the responsibility of the employment offices. In seamless transition cases, health funds almost exclusively rely on the relevant provisions of Book three--employment promotion--of the Social Code. Notwithstanding, sickness benefits frequently extend over the maximum period possible, i.e., 18 months, although the presence of disablement has been confirmed much earlier, and transition into unemployment certainly is no perspective either. Case Managements targeted at keeping disabled persons in employment have now been set up in several Bavarian employment offices. In close cooperation with the health funds' medical services, as well as in a number of other instances, they undertake early interventions to maintain employment, thus seeking to stem the traditional further course of disabled people still employed into the long waiting lines faced with at the rehabilitation agencies, or into unemployment and subsequent costly occupational reorientation, with continued joblessness awaiting them afterwards. The Case Management approach set out and analyzed in this article is intended as a model to be taken up elsewhere, having proven its benefit for people with disabilities while being cost-effective from an overall economic perspective due to its preventing the need to grant unemployment benefits and costly retraining. Guided by rehabilitation counsellors, the Case Managements are directed at rehabilitees and companies alike, and may take action through technical work aids, integration allowances, or skills adjustment programmes. For speedier, focussed implementation of the services offered, they "purchase" support and back-up from experienced agencies in the field, drawing on so-called "free" funding resources available under book three of the Social Code. Very good results using the model outlined have already been reported by the Nuremberg, Traunstein and Würzburg employment offices.

A 16-year-old girl who was treated with ceftriaxone developed two intravascular haemolytic attacks that led to acute renal failure and death. The direct antiglobulin test was positive only for C3d, and no ceftriaxone-dependent antibodies were detectable. Her serum reacted strongly positive with red blood cells in the presence of ex vivo antigen related to ceftriaxone (urine samples from patients receiving the drug). This is the first reported case in which the causative antibodies appeared to be stimulated solely by a degradation product of ceftriaxone.

Nonlinear excitations in the form of kink solitons play an important role in understanding the low-temperature properties of quasi-one-dimensional (1D) magnets and have been widely studied, both theoretically and experimentally, within the last 15 years1–6. Experimental investigations mainly refer to sine-Gordon-like spin chains, such as CsNiF3 3, 6or (CH3)4NMnCl3 (TMMC)4–6. The crystal structure of these two prototypes (and of many other related compounds) is isomorphous: It consists of a hexagonal array of magnetic chains with the magnetic nickel or manganese ions coupled ferro- or antiferromagnetically along the crystallographic c-direction. Intrachain dipolar and crystal field interactions provide for an easy plane, so that the spins tend to align perpendicularly to the chain direction. Applying an external magnetic field within the easy plane, or considering the effect of some symmetry-breaking anisotropy of easy-axis type, we arrive at a Hamiltonian which, using some standard approximations1, can be mapped to a sine-Gordon (SG) model. Thus, most of the experimental investigations on magnetic solitons refer to SG type systems even though the theoretical interpretations applied have generally proceeded beyond that limit7.

NODULARIN-related intoxications have been described in a variety of species, including dogs (Main and others 1977, Beasley and others 1989, van Halderen and others 1995, Duy and others 2000, van Apeldoorn and others 2007, Broker and others 2010). Nodularin is a potent hepatotoxin produced by the cyanobacterium Nodularia spumigena , which can be found in brackish waters in cyanobacterial blooms (Dittmann and Wiegand 2006, van Apeldoorn and others 2007). In recent years, a significant increase in cyanobacterial blooms due to anthropogenic eutrophication of the aquatic ecosystem has been observed worldwide (Pitois and others 2001, Smith 2003). Dogs exposed to nodularin by drinking contaminated water show acute signs of intoxication, such as vomiting and diarrhoea, as a consequence of hepatic and renal failure, and intoxication is often associated with death (Nehring 1993, Harding and others 1995). Although an immunotoxic effect of cyanotoxins has been demonstrated experimentally in vitro as well as in sheep and laboratory rodents, so far, there have been no reports describing alterations of the lymphoid organs in carnivores. This short communication describes cases of intoxication after ingestion of nodularin-contaminated water in two dogs showing depletion of the lymphoid organs as well as the classical changes in the liver and kidneys. Two dogs, a six-month-old French bulldog (dog 1) and a five-year-old crossbreed (dog 2), were presented with a clinical history of acute onset of partly haemorrhagic vomiting and depression after being observed drinking bloom-contaminated water from the German Baltic Sea. These dogs, which both showed changes in their lymphoid organs, were two of three dogs examined …

Anti-glomerular basement membrane (anti-GBM) nephritis occurring in kidneys transplanted in patients with Alport's syndrome (AS) has been reported repeatedly. Therefore, we studied graft survival and course of renal function in all 30 AS patients grafted at Hannover Medical School and compared them with non-diabetic, age and sex matched patients, transplanted on the date closest to the transplantation of the AS patient. Serum creatinine, proteinuria, urinary sediment and anti-GBM antibodies were examined in all AS patients with functioning grafts. Cases of patient or graft loss in the AS group were analyzed retrospectively. One- and five-year patient survival was 100 and 91% in AS and 89 and 78% in controls (p0.05, respectively). One- and five-year first graft survival was 79 and 66% in both groups. Graft histology was available in 34 biopsies obtained from 21 kidneys in 15 AS patients. Anti-GBM nephritis was not detected in any of the biopsies. No graft was lost due to anti-GBM nephritis. Anti-GBM antibodies were detectable temporarily only in one AS patient. He also had linear IgG staining in his graft GBM, but no other signs of anti-GBM nephritis. We conclude that patient survival and graft survival in AS patients following kidney transplantation is not different from non-AS patients. Allograft anti-GBM nephritis is a rare complication in patients with Alport's syndrome.

The presented paper includes the medical records of two girls with adrenal cortical carcinomas on the one hand and the detailed analysis of a collected series of 150 equal cases in pediatric literature on the other hand. In our patients there were a primarily metastatic, non-functioning tumour and a locally invasive, hormone-secreting neoplasm respectively. The latter one produced a Cushing's syndrome with signs of virilization. In this case surgical removal was followed by postoperative irradiation and adjunctive cytostatic therapy with cyclophosphamide and adriamycin for one year. But tumour recurrence occurred within 6 months. A treatment with the antitumour agents aminogluthetimide and o,p' DDD was transiently effective. However drug-induced side effects necessitated the stop of this regimen after 5 months. The analysis of 150 case reports revealed a peak between 1 and 3 years of age, a striking prevalence of the female sex in all age groups, and a metastasizing rate of about 30% at the time of diagnosis. Regional structures, liver and lung were the main locations of metastatic lesions. The occurrence of second primary neoplasms and the association with a group of other conditions particularly congenital disorders have proved to be a remarkable feature of the disease. In primary adrenal cortical tumours the determination of the neoplasm's biological behaviour by morphologic criteria alone can often be very problematical. This fact is especially stressed.

Die tribologisch wirksamen Schichtsysteme TiCxNy und CrNx wurden mittels AES-Tiefenprofil-analyse und REM untersucht. Die Herstellung der Schichten erfolgte durch reaktives Hochleistungszerstauben im BiasMode. Beim ternaren System TiCxNy variierte die Zusammensetzung des Reaktivgasgemisches Stickstoff und Acetylen. Beim binaren System CrNx variierte der Stickstoffanteil im Sputtergas. An den Schichten wurde der Einflus der Herstellungsbedingungen auf die Morphologie, die Elementzusammensetzung und die Mikroharte untersucht. An dem System CrNx wurde daruber hinaus die Oxidationskinetik an Luft im Temperaturbereich ϑ=300° C bis ϑ= 700° C untersucht. Danach beschreibt das √t-Gesetz das Oxidationsverhalten am besten. Nach dem Arrhenius-Ansatz betragt die AktivierungsenergieEa=23,3 Kcal/mol.

CrNand (Ti, Al) N coatings have been deposited by high rate sputter deposition. CrN is one of the most uncritical coatings to produce, neither microhardness nor sputtering stability being influenced by sputtering conditions. Depending upon the nitrogen partial pressure during deposition and the aluminium content, (Ti, Al) N coatings with maximum microhardness values of 2200–3000 HV0.01 can be obtained. Such coatings have superior oxidation and wear resistance compared to normal sputtered TiN coatings.

Bei der Behandlung der ersten 10 Kinder mit unreifzelliger Leukose wurden durch L-Asparaginase 3 Voll- und 3 Teilremissionen erzielt. Die Vollremissionen hielten 10 Wochen, 6 Wochen und 7 Tage an. — Das Spektrum der moglichen Nebenwirkungen der Asparaginasetherapie und die Haufigkeit ihres Auftretens bei unseren Patienten werden geschildert

Die Lokalisation und Innervation der myoendokrinen Zellen im Herz wurde immunhistochemisch untersucht und morphometrisch analysiert. Immunreaktivitat (IR) von Atrialem Natriuretischem Peptid (ANP) wird im Herz vor allem in der Wandung beider Vorhofe sowie in geringerem Mase im ventrikularen Reizleitungssystem angetroffen. Die Innervationsdichte der Vorhofe weist quantitative Unterschiede zwischen den verschiedenen Spezies auf (Meerschweinchen > Hund > Mensch > Ratte > Schwein). Mit Synaptophysin-IR, einem Marker prasynaptischer Vesikel, wurde eine bessere nervose Versorgung der myoendokrinen Zellen im Vergleich zu den Ventrikelmyokardiozyten gemessen. IR von Neuropeptid Y, ein in noradrenergen Varikositaten vorkommendes Peptid, findet sich in extrinsischen und intrinsischen kardialen Neuronen, mit zahlreichen Nervenfasern um Blutgefase und myoendokrine Zellen in den Atria. Immunreaktive Nervenendigungen von Calcitonin-Gene-related-Peptide, das in sensiblen extrinsischen wie intrinsischen Neuronen der kardiovaskularen Innervation vorkommt, sind um die Blutgefase und im Endokard besonders haufig. Fur die Regulation der ANP-Sekretion aus den atrialen myoendokrinen Zellen wird eine speziesspezifische extrinsische und besonders auch intrinsische (intramuraler Regulationskreis) Steuerung diskutiert.

The presented paper includes the medical records of two girls with adrenal cortical carcinomas on the one hand and the detailed analysis of a collected series of 150 equal cases in pediatric literature on the other hand. In our patients there were a primarily metastatic, non-functioning tumour and a locally invasive, hormone-secreting neoplasm respectively. The latter one produced a Cushing's syndrome with signs of virilization. In this case surgical removal was followed by postoperative irradiation and adjunctive cytostatic therapy with cyclophosphamide and adriamycin for one year. But tumour recurrence occurred within 6 months. A treatment with the antitumour agents aminogluthetimide and o,p' DDD was transiently effective. However drug-induced side effects necessitated the stop of this regimen after 5 months. The analysis of 150 case reports revealed a peak between 1 and 3 years of age, a striking prevalence of the female sex in all age groups, and a metastasizing rate of about 30% at the time of diagnosis. Regional structures, liver and lung were the main locations of metastatic lesions. The occurrence of second primary neoplasms and the association with a group of other conditions particularly congenital disorders have proved to be a remarkable feature of the disease. In primary adrenal cortical tumours the determination of the neoplasm's biological behaviour by morphologic criteria alone can often be very problematical. This fact is especially stressed.

In recent years, the identity of the endocrine heart has been established by means of isolation of polypeptide hormones from atria of several species. Antibodies are currently available to perform studies using specific immunohistochemistry and radioimmunoassays in order to investigate these new polypeptides (see reviews 3,4). It soon became evident that the same family of polypeptides was also present in various extra-auricular sites, particularly the central nervous system (6) as well as in the pituitary, the adrenal medulla, the peripheral autonomic nervous system, and the kidney. In addition to these sites, several research groups detected cardiac hormones in the ventricles of lower vertebrates (12). Furthermore, RIA and mRNA results showed that CDD/ANP polypeptides occur in mammalian ventricles. Initial studies demonstrated that atrial peptides are also found in ventricular myoendocrine cells (1,8,13). It has become apparent that the immunoreactive material of cardiac hormones in the ventricle may be confined to the conductive system. We investigated this subject in greater detail by systematically analyzing the heart for the detection of extra-auricular CDD/ANP immunoreactivity using light and electron microscopic immunocytochemistry, RIA, and HPLC combined with RIA and biotests of topographically defined areas of the ventricular tissue.

Recent interest in the storage, release, and action of atrial natriuretic peptide (ANP) in adult mammals has directed our attention to the early appearance, distribution, and possible function of this cardiac hormone during embryonic development. This report summarizes efforts to map and quantify cardiac ANP in developing and neonatal rats, rabbits, and pigs.

In contrast to the data published by Payne and Huntsman in 1982, no association between GLO I and Hp phenotypes could be found in a sample of 973 unrelated Austrians.

The serological findings of three patients suffering from liver cirrhosis and hepatitis accompanied by immunohemolytic anemia (IHA) are described. As a cause of the observed hemolyses the administration of (+)-Cyanidanol-3 (Catergen) was supposed. In contrast to three cases reported in literature antibodies against Catergen were not detectable, therefore a causal connexion between the development of IHA and Catergen could not be proved.

Die Prostata ist ein palpatorisch abschnittsweise gut zugangliches Organ. Da der Urologe mit dem tastenden Finger haufig carcinomverdachtige Knoten und Verhartungen des Organs fuhlt, lag es nahe, diese Veranderungen direkt anzupunktieren, um die klinische Verdachtsdiagnose morphologisch zu untermauern. Diesem Gedanken folgend, entwickelte Franzen [3] 1960 ein einfaches Spezialinstrumentarium zur direkten transrectalen Feinnadel-Aspirationsbiopsie verdachtiger Prostatabezirke. Diese Untersuchung ist fur den Geubten relativ einfach, ambulant und ohne Narkose durchfuhrbar. Sie kann zu Verlaufsbeobachtungen beliebig oft wiederholt werden. Es sind damit unseres Erachtens gegenuber der alteren Methode, der transperinealen Biopsie mit der Vim-Silverman-Nadel, die eine Narkose und einen kurzen stationaren Aufenthalt erforderte und auserdem zu gelegentlichen Komplikationen fuhrte, deutliche Vorteile gegeben [1, 2]. Im Gegensatz zur Vim-Silverman-Nadel, die einen groseren mit histologischen Techniken untersuchbaren Stanzzylinder liefert, wird aber bei der Franzen-Feinnadel-Aspirationsbiopsie Material gewonnen, das sich nur cytologisch aufarbeiten last. In jungerer Zeit wurde von der Fa. Travenol eine Nadel zur transrectalen Histobiopsie der Prostata auf den Markt gebracht, die einfacher und risikoloser anwendbar ist als die Vim-Silverman-Nadel, aber doch mehr traumatisiert als die Franzen-Nadel Eine Vergleichsstudie zwischen Franzen-Nadelbiopsie und Travenol-Nadelbiopsie lauft z. Z. In unserem Haus verwenden die Urologen seit 1968 die von Franzen [3] angegebene Technik, und wir haben 1969 gemeinsam mit Kelâmi [4] uber die ersten 60 bis zum Marz 1969 gewonnenen cytologischen Ergebnisse berichtet. Wir fanden cytologisch 20 Carcinome, die histologisch durch die parallel ausgefuhrte Vim-Silverman-Biopsie oder durch Operation alle bestatigt wurden. Vierzigmal ergab sich cytologisch kein Hinweis auf ein Carcinom, bei den histologischen Kontrollen zeigte sich, das wir nur einen Fall falsch negativ beurteilt hatten.