Search

Hintergrund: Ziel der vorliegenden Studie war die Überprüfung der Interrater-Reliabilität, Validität und Akzeptanz des DIPS Open Access 1.2 (DIPS-OA1.2) in einer Gelegenheitsstichprobe aus der Allgemeinbevölkerung. Methode: Sieben DIPS-zertifizierte Psychologinnen (B.Sc.) führten 144 Interviews durch. Anschließend wurden die durch die Interviewerin gestellten Diagnosen mit denen einer Gegenko­diererin verglichen. Außerdem füllten die Proband:innen nach dem Interview eine Fragebogenbatterie aus. Ergebnisse: Die Ergebnisse sprechen für eine gute bis sehr gute Interrater-Reliabilität aller überprüfbaren Oberklassen und Störungskategorien mit Ausnahme der früheren Diagnosen der Generalisierten Angststörung und der depressiven Störung aufgrund eines anderen medizinischen Krankheitsfaktors. Außerdem deuten die Ergebnisse auf eine gute Validität der Oberklasse Angststörungen sowie eine hohe Ak­zeptanz des DIPS-OA1.2 hin. Schlussfolgerungen: Die Ergebnisse der vorliegenden Studie sind vergleichbar mit denen der Studien zu den Vorgängerversionen des DIPS und deuten auf eine gute Reliabilität, Validität und Akzeptanz des DIPS-OA1.2 in einer Gelegenheitsstichprobe aus der Allgemeinbevölkerung hin. Vor diesem Hintergrund lässt sich festhalten, dass sich das DIPS-OA1.2 insbesondere auch für epidemiologische Studien eignet.

For acute and chronic soft tissue infections, radical surgical debridement is required and is considered the gold standard, along with its immediate systemic antibiotic therapy. Treatment with local antibiotics and/or antibiotic-containing materials is commonly used as an additional tool in clinical practice. Spraying with fibrin and antibiotics is a newer technique that has been studied for some antibiotics. However, for gentamicin, data are not yet available on absorption, optimal application, antibiotic fate at the site and transfer of antibiotic into the blood. In an animal study involving 29 Sprague Dawley rats, 116 back wounds were sprayed with gentamicin using either gentamicin alone or one of two possible spray combinations of gentamicin and fibrin. Simultaneous application of gentamicin and fibrin via a spray system to soft tissue wounds resulted in significant antibiotic concentration over a long period of time. The technique is easy and cost-effective. The systemic crossover was significantly minimized in our study, which may have led to fewer side effects in patients. These results could lead to an improvement in local antibiotic therapy.

Item does not contain fulltext TSPEAR variants cause autosomal recessive ectodermal dysplasia (ARED) 14. The function of TSPEAR is unknown. The clinical features, the mutation spectrum, and the underlying mechanisms of ARED14 are poorly understood. Combining data from new and previously published individuals established that ARED14 is primarily characterized by dental anomalies such as conical tooth cusps and hypodontia, like those seen in individuals with WNT10A-related odontoonychodermal dysplasia. AlphaFold-predicted structure-based analysis showed that most of the pathogenic TSPEAR missense variants likely destabilize the β-propeller of the protein. Analysis of 100000 Genomes Project (100KGP) data revealed multiple founder TSPEAR variants across different populations. Mutational and recombination clock analyses demonstrated that non-Finnish European founder variants likely originated around the end of the last ice age, a period of major climatic transition. Analysis of gnomAD data showed that the non-Finnish European population TSPEAR gene-carrier rate is ∼1/140, making it one of the commonest AREDs. Phylogenetic and AlphaFold structural analyses showed that TSPEAR is an ortholog of drosophila Closca, an extracellular matrix-dependent signaling regulator. We, therefore, hypothesized that TSPEAR could have a role in enamel knot, a structure that coordinates patterning of developing tooth cusps. Analysis of mouse single-cell RNA sequencing (scRNA-seq) data revealed highly restricted expression of Tspear in clusters representing enamel knots. A tspeara (-/-);tspearb (-/-) double-knockout zebrafish model recapitulated the clinical features of ARED14 and fin regeneration abnormalities of wnt10a knockout fish, thus suggesting interaction between tspear and wnt10a. In summary, we provide insights into the role of TSPEAR in ectodermal development and the evolutionary history, epidemiology, mechanisms, and consequences of its loss of function variants.

Because of their low incidence, studies about carpal fractures are rare. The aim of the present study was to analyze epidemiology and treatment of fractured carpal bones. We retrospectively analyzed data of 178 patients admitted to our emergency room with carpal fractures over 6 years. More males than woman were injured. In 91%, a CT scan was performed. The most commonly affected bone was the triquetrum followed by the scaphoid. Almost all triquetral fractures were treated conservatively as opposed to perilunate dislocations that were all operated on. Half of all patients with scaphoid fractures were operated. Young men had the highest risk to sustain a carpal fracture. The triquetrum and the scaphoid are most frequently affected. Usually a CT scan is needed. Treatment of scaphoid and perilunate luxation fractures is rather operative whereas the other fractures mostly allow conservative casting. Nevertheless, correct indication for treatment is important to avoid sequelae.

Introduction In an emergency department, the majority of pediatric trauma patients present because of minor injuries. The aim of this study was to evaluate temporal changes in age-related injury pattern, trauma mechanism, and surgeries in pediatric patients. Methods This retrospective study included patients Results 23,582 patients were included (58% male, median age 8.2 years). There was a slight increase in patients comparing A (n = 11,557) and B (n = 12,025) with no difference concerning demographic characteristics. Significant more patients (A: 1.9%; B: 2.4%) were admitted to resuscitation room, though the number of multiple injured patients was not significantly different. In A (25.5%), major injuries occurred significantly less frequently than in B (27.0%), minor injuries occurred equally. Extremity fractures were significantly more frequent in B (21.5%) than in A (20.2%), peaking at 8–12 years. Most trauma mechanisms of both groups were constant, with a rising of sport injuries at 8–12 years. Conclusion Although number of patients increases only slightly over a decade, there was a clear increase in major injuries, particularly extremity fractures, peaking at 8–12 years. At this age also sport accidents significantly increased. At least, admittance to resuscitation room rose but without an increase of multiple injured patients.

ZusammenfassungDie Erkenntnis, wissenschaftliches Wissen und Methoden für Forschende, Studierende und Interessierte weltweit frei zugänglich zu machen, rückt zunehmend in den Fokus sozial- und kommunikationswissenschaftlicher Debatten in Fachzeitschriften und auf Tagungen. Mit dem vorliegenden Handbuch soll dem Gedanken der Open Science-Bewegung Rechnung getragen werden: Unser Ziel ist es, Wissen über die Anwendungsfelder und die Erhebungsinstrumente der standardisierten Inhaltsanalyse und damit über eine der zentralsten Methoden kommunikationswissenschaftlicher Forschung für WissenschaftlerInnen und Studierende zu sammeln, zu systematisieren, zu reflektieren und im Sinne von open method und open access frei zugänglich zu machen. Denn ganz egal, ob Fragen nach gesellschaftlichen Veränderungen, journalistischen Entscheidungen oder funktionalen und dysfunktionalen Wirkungen von Medien im Fokus der Forschung stehen, die Inhaltsanalyse hilft dabei, Antworten zu finden.

ZusammenfassungWerbung ist ein wichtiger Bestandteil sämtlicher Medieninhalte – trägt sie doch maßgeblich zur Finanzierung der Medien bei und ist somit ein bedeutender medienökonomischer Faktor. Werbeinhalte treffen in der Regel auf RezipientInnen, die nicht bewusst nach diesen Inhalten gesucht haben und der Werbung dementsprechend geringe Aufmerksamkeit entgegenbringen. Das heißt, dass Werbung durch gestalterische Mittel möglichst viel Aufmerksam- und Einprägsamkeit zu generieren versucht, um eine Wirkung auf die Erinnerung und eine Persuasionswirkung entfalten zu können. Bewegte und statische Bilder und das Zusammenspiel von Bild- und Textbotschaften sind daher in der Werbung zentral, stellen für die standardisierte Inhaltsanalyse allerdings auch eine Herausforderung dar. Zahlreiche inhaltsanalytische Studien befassen sich mit den Inhalten von Werbung, die an Kinder oder Heranwachsende als zentrale Zielgruppe gerichtet ist, und dabei dominiert die Frage nach möglichen (negativen) Folgen.

The study investigates the influence of media stereotypes on the degree of presumed media influence on others and the resulting effects for people’s own attitudes toward a minority. We examine how the presumption of negative effects of media stereotypes on others can lead to a correction of one’s own attitude toward Muslims. In an online experiment, we test the relationship among media stereotyping, presumed media effects, and attitudinal and behavioral consequences. The results show that one’s own attitude toward Muslims is corrected when people presume a negative influence of media stereotypes about Muslims on other people.

Introduction Stem cell transplantation is one of the most promising strategies to improve healing in chronic wounds as systemic administration of endothelial progenitor cells (EPC) enhances healing by promoting neovascularization and homing though a high amount of cells is needed. In the following study, we analysed whether local application can reduce the number of EPC needed achieving the same beneficial effect on wound healing. Material and Methods Wound healing after local or systemic treatment with EPC was monitored in vivo by creating standardized wounds on the dorsum of hairless mice measuring wound closure every second day. Systemic group received 2 × 106 EPC i.v. and locally treated group 2 × 105 EPC, locally injected. As control PBS injection was performed the same way. Expression of CD31, VEGF, CD90 and, SDF-1α was analysed immunohistochemically for evaluation of neovascularisation and amelioration of homing. Results Local (7.1 ± 0.45 SD) as well as systemic (6.1 ± 0.23 SD) EPC transplantation led to a significant acceleration of wound closure compared to controls (PBS local: 9.7 ± 0.5 SD, PBS systemic 10.9 ± 0.38 SD). Systemic application enhanced CD31 expression on day 6 after wounding and local EPC on 6 and 9 in comparison to control. VEGF expression was not significantly affected. Systemic and local EPC treatment resulted in a significantly enhanced SDF-1α and CD90 expression on all days investigated. Conclusion Local as well as systemic EPC treatment enhances wound healing. Moreover, beneficial effects are obtained with a tenfold decrease number of EPC when applied locally. Thus, local EPC treatment might be more convenient way to enhance wound healing as number of progenitor cells is limited.

Purpose The primary treatment goals for advanced-stage thumb carpometacarpal (CMC) joint osteoarthritis are complete pain relief and restoration of thumb strength. The purpose of the present study was to introduce a variation of the abductor pollicis longus (APL) suspension arthroplasty using a single looping of a radial slip from the APL tendon around the flexor carpi radialis (FCR) tendon combined with RegJoint™ interposition and to determine its efficacy in the treatment of thumb CMC joint osteoarthritis. Methods Between 2015 and 2017, 21 patients were included. The average age was 60.8 years (range 48–79). The mean follow-up was 27.7 months (range 8–50). Evaluation included pain, radial and palmar abduction, tip pinch and grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Results Pain averaged 0.3 (range 0–4) at rest and 1.4 (range 0–4) on exertion. The radial and palmar abduction were 97% and 99% compared to the contralateral side. The tip pinch and grip strength were 4.1 kg (range 3–6.5) and 22 kg (range 13.3–40), respectively. The DASH score accounted for 18.5 (range 0.8–41.7). Conclusion The modified APL suspension interposition arthroplasty was an efficient and simplified option for the treatment of thumb CMC joint osteoarthritis, with results comparable or better than other published procedures. The APL suspension technique was easy to perform avoiding difficult bone tunneling and incision of the FCR tendon. The RegJoint™ interposition as spacer prevented impingement of the first metacarpal base on the second metacarpal base or the trapezoid bone.

Assisting the Forgotten Ones - Interventions for Children of Parents with Psychological Disorders Mental diseases are associated with high levels of distress in various areas of life for those, who are affected. Taking a closer look at the social circumstances, not exclusively the people themselves but also their family members are affected, especially children. In adult treatment these children are often neglected, even if they have a higher risk of suffering a mental illness themselves. A huge amount of this risk is related to the special family environment children are often exposed to right after birth. We already find prevention programs helping these children and their parents to protect their mental health. These programs largely differ regarding parental psychopathology, setting or intensity. This article gives an overview of the special circumstances these children may be confronted with and hence derivates possible starting points to support affected families. A few existing programs will be described in detail. Empirical findings presented in the article give hope for the effectiveness of already existing programs and besides highlight the need for further research and changes in the care system.

Background Cognitive models of panic disorder (PD) highlight the role of panic-related associations and interpretations. However, results are mixed and rely on specific measures. This study examined panic-related associations and interpretations using established and new paradigms in individuals varying on anxiety sensitivity (AS). Methods Associations were measured using a priming task and a novel Single Target Implicit Association Test (STIAT); interpretations were assessed using the Interpretation Bias Questionnaire (IBQ) and a novel Scrambled Sentences Task (SST). Symptoms were assessed via a provocation task (Straw Breathing Task, SBT). Results Panic-related interpretations correlated with AS and other PD-related measures. Of the association tasks, only the priming task correlated with one of the other PD-related measures. Panic-related interpretations assessed via the SST, but not priming, STIAT, and IBQ, predicted SBT reactivity. The relationship between AS and SBT reactivity was mediated by panic-related interpretations. Conclusions Our data provide support for panic-related interpretations as an important cognitive mechanism.

The spectrum of somatic genetic variation in colorectal adenomas caused by biallelic pathogenic germline variants in the MSH3 gene, was comprehensively analysed to characterise mutational signatures and identify potential driver genes and pathways of MSH3-related tumourigenesis. Three patients from two families with MSH3-associated polyposis were included. Whole exome sequencing of nine adenomas and matched normal tissue was performed. The amount of somatic variants in the MSH3-deficient adenomas and the pattern of single nucleotide variants (SNVs) was similar to sporadic adenomas, whereas the fraction of small insertions/deletions (indels) (21–42% of all small variants) was significantly higher. Interestingly, pathogenic somatic APC variants were found in all but one adenoma. The vast majority (12/13) of these were di-, tetra-, or penta-base pair (bp) deletions. The fraction of APC indels was significantly higher than that reported in patients with familial adenomatous polyposis (FAP) (p < 0.01) or in sporadic adenomas (p < 0.0001). In MSH3-deficient adenomas, the occurrence of APC indels in a repetitive sequence context was significantly higher than in FAP patients (p < 0.01). In addition, the MSH3-deficient adenomas harboured one to five (recurrent) somatic variants in 13 established or candidate driver genes for early colorectal carcinogenesis, including ACVR2A and ARID genes. Our data suggest that MSH3-related colorectal carcinogenesis seems to follow the classical APC-driven pathway. In line with the specific function of MSH3 in the mismatch repair (MMR) system, we identified a characteristic APC mutational pattern in MSH3-deficient adenomas, and confirmed further driver genes for colorectal tumourigenesis.

Zusammenfassung Hintergrund Im Nationalen Kompetenzbasierten Lernzielkatalog Chirurgie (NKLC) wurden den 230 Lernzielen Kompetenzebenen zugeordnet, die von „Kompetenzebene 1: Faktenwissen“ bis „Kompetenzebene 3: selbstständiges Handeln“ reichen. Allerdings basiert die Konzeption des 2. Saatsexamens nicht auf dem NKLC, obwohl der Einfluss von summativen Prüfungen auf das Lernverhalten von Studierenden als erwiesen gilt.Die durchgeführte Studie analysiert den Anteil an handchirurgischen Lernzielen im NKLC und vergleicht die Ergebnisse mit den gestellten handchirurgischen Prüfungsfragen im schriftlichen 2. Staatsexamen. Material und Methoden Retrospektiv wurden die Examensfragen von Herbst 2009 bis Herbst 2014 (n = 11) analysiert. Es wurden Lernziele mit Bezug zur Handchirurgie durch 5 Fachärzte mit Zusatzweiterbildung Handchirurgie und/oder dem „European Board of Hand Surgery“-Diplom identifiziert. Anschließend wurden in den untersuchten Staatsexamina diejenigen Fragen identifiziert, die sich auf handchirurgische Lernziele bezogen. Die Analyse umfasste die Gesamtzahl der Fragen, die Anzahl der Fragen pro Examen sowie pro Lernziel und Kompetenzebene. Ergebnisse 47 Lernziele des NKLC (20,4 % aller Lernziele des NKLC) wurden dem Fach Handchirurgie zugeordnet. 9 dieser 47 Lernziele (3,9 % aller Lernziele des NKLC) wurden ausschließlich von der Handchirurgie abgedeckt.220 Fragen (6,3 % aller 3480 gestellten Fragen) adressierten diese 47 Lernziele. Dabei wurden pro Examen durchschnittlich 20 ± 8,2 Fragen (Min. 9; Max. 37) mit Bezug zur Handchirurgie gestellt. Pro Examen wurden 0,5 ± 0,7 Fragen (Min. 0; Max. 2) gestellt, die nur von der Handchirurgie abgedeckt werden.Im Studienzeitraum wurden 16 Lernziele mit Bezug zur Handchirurgie gar nicht geprüft (13,7 % aller Lernziele des NKLC), darunter 6 Lernziele, die nur durch das Fach Handchirurgie adressiert werden. Unter den nicht-geprüften Lernzielen finden sich 5 LZ der Kompetenzebene 1 (10,6 % aller handchirurgischen Lernziele der Kompetenzebene 1), 6 Lernziele der Kompetenzebene 2 (12,8 % aller handchirurgischen Lernziele der Kompetenzebene 2) und 5 Lernziele der Kompetenzebene 3 (10,6 % aller handchirurgischen Lernziele der Kompetenzebene 3). Schlussfolgerung Die Anzahl der Lernziele im NKLC, die nur von der Handchirurgie abgedeckt wird, erscheint hoch. Allerdings werden viele dieser Lernziele im 2. Staatsexamen nicht abgebildet. Eine bessere Anpassung der Staatsprüfung an den Lernzielkatalog ist wünschenswert.

Peptoids, or poly-N-substituted glycines, are characterised by broad structural diversity. Compared to peptides, they are less restricted in rotation and lack backbone-derived H bonding. Nevertheless, certain side chains force the peptoid backbone into distinct conformations. Designable secondary structures like helices or nanosheets arise from this knowledge. Herein, we report the copper-catalysed alkyne-azide cycloaddition (CuAAC) of macrocycles to form innovative tube-like tricyclic peptoids, giving access to host&ndash, guest chemistry or storage applications. Different linker systems make the single tubes tuneable in size and enable modifications within the gap. An azobenzene linker, which is reversibly switchable in conformation, was successfully incorporated and allowed for light-triggered changes of the entire tricyclic structure.

Zusammenfassung Psychische Erkrankungen gehen für die Betroffenen mit hohen Belastungen in verschiedenen Lebensbereichen einher. Im familiären Bereich betreffen diese oft nicht nur die Person selbst, sondern auch die anderen Familienmitglieder, vor allem Kinder. Suchen sich die Betroffenen (psychotherapeutische) Unterstützung, fallen diese Angehörigen oft durch das Versorgungsraster. Dabei haben Kinder der Betroffenen ein deutlich höheres Risiko, selbst eine psychische Erkrankung zu erleiden. Ein Großteil dieses Risikos ist auf ihre Lebenswelt zurückzuführen, die oft von Geburt an besondere Umstände mit sich bringt. Im Versorgungsfeld existieren bereits einige wenige Präventions- und Interventionsangebote für diese Familien, die sich in der Spezifität, im Setting und in der Intensität der Hilfestellung unterscheiden. Der vorliegende Artikel bietet einen Überblick über die besondere Lebenswelt von Kindern psychisch kranker Eltern, Probleme in betroffenen Familien und die daraus ableitbaren Möglichkeiten für Hilfsangebote. Die dargestellten empirische Befunde geben Hoffnung für die Wirksamkeit bereits bestehender Programme und machen dennoch den weiteren Bedarf an Forschung und an Änderungen im Versorgungssystem deutlich, damit Kinder psychisch kranker Eltern nicht länger durch die Versorgungsnetze fallen.

Why do infants remember some things and not others? Human infants frequently cycle through different states such as calm attentiveness, wakeful activity, and crying. Given that cognitive processes do not occur in isolation, such fluctuations in internal state might influence memory processing. In the present experiment, declarative memory in 9-month-old infants (N = 96) was heavily state dependent. Infants exhibited excellent retention of a deferred imitation task after a 15-min delay if their state at encoding was identical to their state at retrieval (e.g., calm). Infants failed to exhibit retention if their state at encoding was different from their state at retrieval (e.g., calm vs. animated). Infant memory processing depends on internal cues.

Die typischen Verletzungen der Handwurzel finden sich meist nach einem Sturz auf das uberstreckte Handgelenk bzw. bei komplexen Lasionen nach schwerem Trauma, z. B. Absturz aus groser Hohe, Motorradunfall, bzw. bei Begleitverletzungen nach Polytrauma. Die charakteristischen Verletzungsmechanismen, Lasionsmuster und das diagnostische Vorgehen bei den bekannten Bandlasionen (skapholunar, lunotriquetral, perilunar) erfreuen sich breiter Bekanntheit und damit zunehmender konsequenter Versorgung. Diese umfasst z. B. in der Fruhphase die Bandnaht oder bei unzureichendem Bandmaterial die Augmentationen. Entsprechend werden begleitende Knochenlasionen mitversorgt und die betroffenen Gelenkabschnitte meist mithilfe der Kirschner-Draht-Transfixation in Kombination mit einem Gips bzw. einer stabilen Orthese zur Ausheilung gebracht. Wesentlich problematischer sind Bandverletzungen bzw. Instabilitaten, die nicht klar auf einen Unfallmechanismus zuruckzufuhren sind oder gar Bandlaxizitaten bzw. hypermobile Situationen, die angeboren sind. Diese ausern sich meist in Form von Uberlastungsbeschwerden und werden haufig als Tendovaginosen beschrieben bzw. fehldiagnostiziert.

In der Notaufnahme ist, abgesehen von Prellungen und Platzwunden im Bereich des Kopfes, die Hand mit 20–25 % einer der am haufigsten verletzten Korperabschnitte beim Kind. Es finden sich unterschiedliche Verletzungsmuster von banalen bis operationsbedurftigen komplexen Verletzungen. Dabei zeigen sich deutliche Unterschiede bei den Verletzungen zwischen Kleinkindern und alteren Kindern. Der Fus ist von Verletzungen deutlich seltener betroffen (5–10 %). Hier herrschen banale Weichteilverletzungen wie Prellungen vor. Aufwendige Weichteilrekonstruktionen sind daher mehr im Bereich der Hand notwendig. Hier kommt es in knapp 10 % zu Amputationsverletzungen bzw. Sehnen- und Nervenverletzungen.

Achieving stable fixation of scaphoid fractures and nonunions continues to be a challenge. Compression screw fixation has been the current standard surgical procedure. However, in some cases, bone healing cannot be achieved and requires further revision. Recent series reintroduced volar plating as valid option for stable fixation. The aim of the study was to review clinical outcome of alternative scaphoid treatment. From 2011 to 2014, nine patients with scaphoid fracture were treated by Headless Compression Screw (HCS) and seven patients with scaphoid nonunion by HCS or volar mini condylar plate with bone graft. The average age was 34.4 years and the average time to follow-up was 19.3 months. From 1996 to 1998, 38 patients with scaphoid nonunion were treated using compression screw (S-group) or volar mini condylar plate (P-group) with bone graft. The average age was 39.6 years and the average time to follow-up was 26.2 months. The union rate was 100%. For scaphoid fractures, the mean Modified Mayo Wrist Score (MMWS) was 94.1 and the DASH score 7.4. From 2011 to 2014, the MMWS was 87.9 and the DASH score 7 in scaphoid nonunions. In the period between 1996 and 1998, the MMWS was 67.2 in the P-group and 58.6 in the S-group, and the DASH score 16.8 and 28.2. Our study demonstrated that appropriate application of the HCS was able to produce very satisfactory results in scaphoid fractures and nonunions. In our opinion, however, the method of scaphoid plate osteosynthesis can achieve a higher degree of stability, particularly rotational stability, in case of multifragmentary avascular scaphoid nonunions.

Background Radioresistance is a common feature of head and neck squamous cell carcinoma (HNSCC). We previously showed that the irradiation- activated vascular endothelial growth factor (VEGF)-extracellular signal-regulated kinase (ERK)-axis is fundamental for the survival of resistant tumors. In this study, we examined if treatment with potent multikinase (MK) inhibitors, sorafenib and sunitinib, could radiosensitize tumor cells. Methods Cultured HNSCC cell lines were treated with inhibitors and subsequently irradiated. Radiosensitizing effects were functionally assessed by annexin-V apoptosis and clonogenic assays and confirmed by Western blot. Additionally, we surveyed human HNSCC tissue microarrays (TMAs) for activated ERK expression. Results Based on combination indexes, we found that combining irradiation with both inhibitors exerted strong and supra-additive antitumor effects on clonogenic survival. Kinase inhibition enhanced irradiation-induced apoptotic rates and inhibited postradiogenic phospho-ERK-expression. Patients with recurrent HNSCC displayed significantly lower extracellular signal-regulated kinase phosphorylation (pERK) levels than relapse-free patients. Conclusion We propose further evaluation of sorafenib and sunitinib as potential radiosensitizing agents in HNSCC treatment. © 2017 Wiley Periodicals, Inc. Head Neck 39: 623–632, 2017

Purpose Triangular fibrocartilage complex (TFCC) lesions have high clinical relevance. Although multiple studies have been done in the past, there is a lack of data after conservative treatment and controversy remains regarding management. The purpose of this study was to compare the outcome of symptomatic TFCC lesions after conservative treatment and arthroscopic debridement. Methods Between 2012 and 2017, 33 patients were included. 16 patients were treated conservatively and 17 patients with arthroscopic debridement. The average age was 41 years (range 18–63). The mean follow-up was 22.2 months (range 6–74). Evaluation included pain, range of motion (ROM), grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Modified Mayo Wrist Score (MMWS), and Purdue Pegboard test. Results Pain averaged 0.1 (range 0–1) in the conservative group compared to 1.3 (range 0–6) in the arthroscopic group. The mean ROM was 99% for wrist extension, and 100% for flexion and pro-/supination in the conservative group, and 96% for extension and flexion, and 100% for pro-/supination in the arthoscopic group compared to the contralateral side. Grip strength was 88% (range 63–100) in the conservative group versus 89% (range 33–100) in the arthroscopic group. The conservative group reached a DASH score of 16.8 and MMWS of 94.3 compared to 22.1 and 87.2 in the arthroscopic group. The differences were not statistically significant. Conclusions Our study demonstrated similar results of conservative compared to arthroscopic treatment. Because conservative treatment was a sufficient and reliable option, we propose it as first-line treatment for TFCC lesions with stable distal radioulnar joint.

The national competency-based catalogue of learning objectives in surgery (NKLC) for undergraduate surgical education in Germany consists of 230 objectives and defines competence levels for each objective. These levels range from "competence level 1: factual knowledge" to "competence level 3: independent action". The German second state examination is not based on these objectives, although it is known that assessment drives learning. This study analyses the proportion of hand surgery-based learning objectives in the NKLC and compares the results with the hand surgery questions of the German second medical licensing examination compiled by the Central German Institute for Medical and Pharmaceutical Examinations (IMPP).Hand surgery teaching objectives in the NKLC were identified by five hand surgeons. All exam questions addressing these objectives were identified in the German second medical licensing examinations held from autumn 2009 through autumn 2014 (n = 11). The analysis included the number of hand surgery questions for each examination, the number of learning objectives and the different levels of competence.Forty-seven learning objectives of the NKLC were identified as "hand surgery-related" (20.4 % of all NKLC learning objectives). Nine of them were classified as learning objectives that were "only covered by hand surgery" (3.9 % of all NKLC learning objectives). Two hundred and twenty questions (6.3 % of the total number of 3480 questions) addressed hand surgery-related objectives. Per exam, an average of 20 ± 8.2 questions (minimum: 9; maximum: 37) addressed a hand surgery-related learning objective. An average of 0.5 ± 0.7 questions per exam were related to objectives that only covered hand surgery (minimum: 0; maximum: 2). During the study period, 16 learning objectives were not tested at all (13.7 % of all NKLC learning objectives). These untested objectives included 5 objectives of competence level 1 (10.6 % of all NKLC learning objectives). Six of the 9 objectives that are only covered by hand surgery were not assessed at all.The number of hand surgery-based learning objectives in the NKLC appears to be high. However, many of these learning objectives are not addressed in the second medical licensing examination. We recommend better adjustments between the state examinations and the NKLC.Im Nationalen Kompetenzbasierten Lernzielkatalog Chirurgie (NKLC) wurden den 230 Lernzielen Kompetenzebenen zugeordnet, die von „Kompetenzebene 1: Faktenwissen“ bis „Kompetenzebene 3: selbstständiges Handeln“ reichen. Allerdings basiert die Konzeption des 2. Saatsexamens nicht auf dem NKLC, obwohl der Einfluss von summativen Prüfungen auf das Lernverhalten von Studierenden als erwiesen gilt.Die durchgeführte Studie analysiert den Anteil an handchirurgischen Lernzielen im NKLC und vergleicht die Ergebnisse mit den gestellten handchirurgischen Prüfungsfragen im schriftlichen 2. Staatsexamen.Retrospektiv wurden die Examensfragen von Herbst 2009 bis Herbst 2014 (n = 11) analysiert. Es wurden Lernziele mit Bezug zur Handchirurgie durch 5 Fachärzte mit Zusatzweiterbildung Handchirurgie und/oder dem „European Board of Hand Surgery“-Diplom identifiziert. Anschließend wurden in den untersuchten Staatsexamina diejenigen Fragen identifiziert, die sich auf handchirurgische Lernziele bezogen. Die Analyse umfasste die Gesamtzahl der Fragen, die Anzahl der Fragen pro Examen sowie pro Lernziel und Kompetenzebene.47 Lernziele des NKLC (20,4 % aller Lernziele des NKLC) wurden dem Fach Handchirurgie zugeordnet. 9 dieser 47 Lernziele (3,9 % aller Lernziele des NKLC) wurden ausschließlich von der Handchirurgie abgedeckt.220 Fragen (6,3 % aller 3480 gestellten Fragen) adressierten diese 47 Lernziele. Dabei wurden pro Examen durchschnittlich 20 ± 8,2 Fragen (Min. 9; Max. 37) mit Bezug zur Handchirurgie gestellt. Pro Examen wurden 0,5 ± 0,7 Fragen (Min. 0; Max. 2) gestellt, die nur von der Handchirurgie abgedeckt werden.Im Studienzeitraum wurden 16 Lernziele mit Bezug zur Handchirurgie gar nicht geprüft (13,7 % aller Lernziele des NKLC), darunter 6 Lernziele, die nur durch das Fach Handchirurgie adressiert werden. Unter den nicht-geprüften Lernzielen finden sich 5 LZ der Kompetenzebene 1 (10,6 % aller handchirurgischen Lernziele der Kompetenzebene 1), 6 Lernziele der Kompetenzebene 2 (12,8 % aller handchirurgischen Lernziele der Kompetenzebene 2) und 5 Lernziele der Kompetenzebene 3 (10,6 % aller handchirurgischen Lernziele der Kompetenzebene 3).Die Anzahl der Lernziele im NKLC, die nur von der Handchirurgie abgedeckt wird, erscheint hoch. Allerdings werden viele dieser Lernziele im 2. Staatsexamen nicht abgebildet. Eine bessere Anpassung der Staatsprüfung an den Lernzielkatalog ist wünschenswert.