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Mit dem Ziel einer erhohten Teilnahmerate bei der Darmkrebsvorsorge machen Stiftungen und Krankenkassen durch ihre Aktivitaten auf das Thema aufmerksam. Fur die Akzeptanz spielt die Kommunikation der Ratsuchenden mit den Arzten eine grose Rolle.

High-current discharge channels are ideally suited for the focusing and transport of intense charged particle beams. The azimuthal magnetic field provides a strong focusing force, which acts symmetrically towards the discharge axis. A sufficiently dense and hot plasma can also neutralize the beam current and space charge of very intense ion beams, relevant to a number of future applications. In this paper we present experiments on high-current discharge channels designed for the transport of heavy ion beams. A spectroscopic method is introduced, which allows us to determine both the plasma temperature and density in hydrogen–nitrogen plasmas, from comparisons of the measurements with computer calculations. The temperature is derived from a comparison of experimentally obtained relative nitrogen-line intensities with a collisional radiative rate modelling of the nitrogen plasma. The electron density is determined by a detailed line shape analysis of the Stark-broadened hydrogen Balmer lines.

Ion-beam transport in space charge neutralizing discharge channels has been proposed for the final focus and chamber transport in a heavy-ion fusion reactor. A driver scenario with two-sided target illumination requires a system of two intersecting discharges to transport beams of the same charge from opposite sides towards the fusion target. In this article we report on experiments on the creation of free-standing, intersecting high-current discharge channels. The discharges are initiated in ammonia gas (NH3) in a metallic chamber by two perpendicular CO2-laser beams, which resonantly heat and subsequently rarefy the gas along the laser paths before the breakdown. These low density channels guide the discharges along the predefined paths and also around the 90° angles without any mechanical guiding structures. In this way stable X-, T-, and L-shaped discharges with currents in excess of 40 kA, at pressures of a few mbar were created with a total length of 110 cm. An 11.4 A MeV 58Ni+12 beam from the UNILA...

The aim of the presented experiments is to study the transport of a heavy ion beam in a high-current plasma channel. The discharge is initiated in NH3 gas at pressures between 2 and 20 mbar by a line-tuned CO2 laser. A stable discharge over the entire electrode gap (0.5 m) was achieved for currents up to 60 kA. Concerning the ion beam transport, the magnetic field distribution inside the plasma channel has to be known. The ion-optical properties of the plasma channel have been investigated using different species of heavy ions (C, Ni, Au, U) with 11.4 MeV/u during six runs at the Gesellschaft für Schwerionenforschungs-UNILAC linear accelerator. The high magnetic field allowed the accomplishment of one complete betatron oscillation along the discharge channel. The results obtained up to now are very promising and suggest that, by scaling the discharge gap to longer distances, the beam transport over several meters is possible with negligible losses.

Discharge plasma channels have been investigated in recent years at Gesellschaft für Schwerionenforschung–Darmstadt (GSI) and at the Lawrence Berkeley National Laboratory in Berkeley, California, in a number of experiments. A short summary of the experimental work at Berkeley and GSI is given. Different initiation mechanisms for gas discharges of up to 60 kA were studied and compared. In the Berkeley experiments, laser ionization of organic vapors in a buffer gas was used to initiate and direct the discharge while at GSI, laser gas heating and ion-beam-induced gas ionization were tested as initiation mechanisms. These three initiation techniques are compared and the stability of the resulting discharge channels is discussed. A discharge current of 50 kA, a channel diameter well below 1 cm, a pointing stability better than 200 μm, and MHD stability of more than 10 μs have been demonstrated simultaneously in the recent experiments. These parameters are sufficient or close to the requirements of a reactor application depending on the details of the target design. The experimental results show that transport channels work with sufficient stability, reproducibility, and ion optical properties for a wide pressure range of discharge gases and pressures.

High current discharge channels can neutralize both current and space charge of very intense ion beams. Therefore they are considered as an interesting alternative for the final focus and beam transport in a heavy ion beam fusion reactor. At the GSI accelerator facility, 50 cm long, stable, free-standing discharge channels with currents in excess of 40 kA in 2 to 25 mbar ammonia (NH{sub 3}) gas are investigated for heavy ion beam transport studies. The discharges are initiated by a CO{sub 2} laser pulse along the channel axis before the discharge is triggered. Resonant absorption of the laser, tuned to the {nu}{sub 2} vibration of the ammonia molecule, causes strong gas heating. Subsequent expansion and rarefaction of the gas prepare the conditions for a stable discharge to fulfill the requirements for ion beam transport. This paper describes the laser-gas interaction and the discharge initiation mechanism. We report on the channel stability and evolution, measured by fast shutter and streak imaging techniques. The rarefaction of the laser heated gas is studied by means of a hydrocode simulation.

Quality assurance activities in Germany have a long tradition of being oriented to structural quality. For many years quality assurance in hospitals was limited to pathologist's examinations and ward rounds. The separation of health care services into in-patient and out-patient sectors has made it difficult to introduce a total quality management system. After passage of a revised social security act on quality assurance, physicians' organizations started quality management projects, which for the most part are still in the pilot phase. Many institutions and commissions are trying to develop quality assurance activities focusing on formulating practice guidelines. However, in order to make quality management a truly vital part of health care in Germany, adequate computerized documentation systems will need to be introduced.

Strong and unstoppable technologic, scientific, social, and business trends are already dramatically influencing the industrial hygiene profession. As it moves into the third millennium, change will accelerate at an even faster pace. Hygienists will have little control over events and trends, so they must attempt to respond to them effectively and positively. This paper is a review and analysis of the literature. It identifies several significant trends and their potential impact on occupational and environmental hygiene. The trends include the continuing shift from a manufacturing to information economy, the globalization of manufacturing, the impact of genetic engineering on medicine and agriculture, the growth of world populations and their impact on the environment.

The final beam transport in the reactor chamber for heavy ion fusion in preformed plasma channels offers many attractive advantages compared to other transport modes. In the past few years, experiments at the Gesellschaft für Schwerionenforschung (GSI) accelerator facility have addressed the creation and investigation of discharge plasmas, designed for the transport of intense ion beams. Stable, self-standing channels of 50 cm length with currents up to 55 kA were initiated in low-pressure ammonia gas by a CO2-laser pulse along the channel axis before the discharge is triggered. The channels were characterized by several plasma diagnostics including interferometry and spectroscopy. We also present first experiments on laser-guided intersecting discharges.

The AIMS™-45, when used in scanner mode, can emulate image intensity as seen in resist on the wafer at scanner illumination conditions. We show that this feature makes AIMS™-45 well-suited to analyze patterns treated with inverse lithography. We have used an inverse lithography technique by Mentor Graphics, to treat a random contact hole layout (drawn at minimal pitch 115nm) for imaging at NA 1.35. The combination of the dense 115nm pitch and available NA of 1.35 makes Quasar illumination necessary, and the inverse lithography treatment automatically generated optimal (model-based) Assist Features (AF) for all geometries in the design. The mask, after inverse lithography treatment, has CH patterns with numerous AF of different sizes and orientations, and is a challenge for both mask making and mask qualification. We have analyzed the inverse lithography masks with the model-based AF using an AIMS™-45 aerial image measurement tool, and compare the results of the AIMS™-45 to wafer data obtained after exposure on an ASML XT:1900i. A first benefit of AIMS™-45 is that the most meaningful quantity (image in resist) is generated without the intermediate steps of doing multiple reticle SEM measurements followed by extensive simulation. A second point of interest is that the AIMS™-45 generates image intensities, which allows a direct validation of the intensity-driven inverse litho conversion. Both features prove the value of the AIMS™-45 for analyzing inverse litho masks and geometries.

SUMMARY Screening colonoscopy is an effective means for early detection of colorectal carcinoma. Any exhaustive evaluation of the method must take further factors into account: epidemiology of colorectal adenomas and carcinomas in the target population, acceptance by the patients, structure, process, and outcome quality, and health economics. Methods: The internet-based colonoscopy database of the Bavarian Association of Statutory Health Insurance Physicians (ASHIP) for the year 2006 includes data on 86.05% of all outpatient colonoscopies performed in Bavarian ASHIP patients, or a total of 245 263 documented examinations. Results: The rate of participation in preventive colonoscopies was low (1.5%) and showed considerable geographical variation. The rate of detection of histologically confirmed colorectal neoplasia in symptom-free screened individuals was almost 26.0%. Some 1.3% of those screened had colorectal carcinoma. In 76.31% of the participants a completely clean gut was achieved. The incidence of bleeding, perforation, and cardiorespiratory complications was 0.22%, 0.03%, and 0.06%, respectively. Discussion: The complication rate of outpatient colonoscopy is on the order of tenths of a percent, while the process quality is high. The rate of detection of colorectal adenoma and carcinoma is high and the projected benefits for public health are considerable, but the rate of participation is too low. Dtsch Arztebl Int 2008; 105(24): 434-40 DOI: 10.3238/arztebl.2008.0434

High level disinfection and infection control in reprocessing gastrointestinal endoscopes is a critical security factor for patients in gastrointestinal health care. National and international guidelines for an adequate high quality disinfection of gastrointestinal endoscopes have been developed aiming to obtain infection control. The German Medical Association has recently published recommendations on quality assurance in gastrointestinal endoscopy including standardised procedures for disinfection and infection control. A prospective study was carried out in a large urban area in both private practices and hospitals to identify and characterise flaws and limitations in disinfection of gastrointestinal endoscopes by measuring a set of indicators of the quality of structures, processes and outcomes. Moreover, the influence of information and continuous medical education on the quality of disinfection and infection control were to be evaluated. The bacterial contamination of endoscopes after reprocessing was measured as a relevant outcome quality indicator. The results revealed substantial flaws in cleaning and disinfection procedures in gastrointestinal endoscopy under routine clinical conditions. Overall, 49 and 39 percent of all (pre- and post-interventionally, resp.) checked endoscopes were contaminated by one or more bacteria. More often failures were discovered in the optic rinse system than in the cleaning/disinfection and the final rinse and drying process. A substantial failure rate was detected in gastrointestinal endoscope reprocessing under routine conditions according to the reprocessing procedure. Compared to manual and semi-automatic cleaning and disinfection, the full automatic cleaning and disinfection machines (RDG-E) showed the best results. Though their cleaning process remains improveable, it seems advisable to prefer RDG-E-machines for disinfection and infection control in gastrointestinal endoscopy. Continuous quality control of disinfection should be obtained by introducing regular microbiological examinations of the reprocessed endoscopes. Negative microbiological controls of the contamination of endoscopes are suitable quality indicators of a quality management system aiming to improve the quality of structures, processes and outcomes in gastroenterological health care.

The protection of people and physical assets is the objective of health and safety professionals and is accomplished through the paradigm of anticipation, recognition, evaluation, and control of risks in the occupational environment. Risk assessment concepts are not only used by health and safety professionals, but also by business and financial planners. Since meeting health and safety objectives requires financial resources provided by business and governmental managers, the hypothesis addressed here is that health and safety risk decisions should be made with probabilistic processes used in financial decision-making and which are familiar and recognizable to business and government planners and managers. This article develops the processes and demonstrates the use of incident probabilities, historic outcome information, and incremental impact analysis to estimate risk of multiple alternatives in the chemical process industry. It also analyzes how the ethical aspects of decision-making can be addressed in formulating health and safety risk management plans. It is concluded that certain, easily understood, and applied probabilistic risk assessment methods used by business and government to assess financial and outcome risk have applicability to improving workplace health and safety in three ways: 1) by linking the business and health and safety risk assessment processes to securing resources, 2) by providing an additional set of tools for health and safety risk assessment, and 3) by requiring the risk assessor to consider multiple risk management alternatives.

Increasingly, environmental, health, and safety (EHS) practitioners are reporting that it is becoming more difficult to sell investments in health and safety, and environmental management. Global competition, government downsizing—including ongoing efforts to re-engineer Safety and Health regulatory agencies and their underlying legislation changes in technology, and the overall drive by organizations to improve operating efficiency have placed added pressure on EHS practitioners. This pressure manifests itself by placing increased financial accountability on all staff functions, including EHS. Business, economics, and environmental management literature have increasingly devoted space for articles concerning such topics as performance measures, quality management, cost control and management, cost and benefit analyses, environmental liabilities, business and environmental management integration, EHS management systems, and EHS performance and the valuation of firms, among many other topics. It is clear that the expectations of senior executives for EHS performance have changed. EHS practitioners must continue to come to the workplace with exceptional academic education and training in the sciences and engineering, but business and communication tools are also needed to successfully meet the new performance challenges. This chapter presents the basic concepts of financial and quality management tools to plan, manage, measure, and control EHS activities, so they may be considered as investments and not pure cost. The goal of this chapter is to demonstrate that EHS practitioners can begin to integrate their technical disciplines into the “business of business”. In some cases, the business and financial tools presented are not commonly used by EHS organizations today. In such instances, the discussion focuses on advantages and benefits of using such tools. By using the tools presented in this chapter practitioners will be better able to manage EHS activities to drive improved EHS performance and to facilitate greater line management interest and involvement in this critical business function. These tools are useful to all EHS practitioners, regardless of whether they organizationally reside in private, public or nonprofit sectors of the economy. Keywords: Issues; Need for change; Performance Measurement; Financial methods; Capital budgeting; Activity-based analysis; Environmental accounting; Direct costs; Indirect costs; Hidden impacts; Health and safety performance metrics; Systems thinking; Systems dynamics

Industrial hygiene issues have a significant impact on all aspects of responding to hazardous material emergencies and on the process of cleaning up a hazardous material spill. The health and safety of all response and cleanup personnel depend on effective evaluation of potential exposures and expert determination of the appropriate means to protect against those exposures. This chapter covers how the professional judgment, expertise, and training of the industrial hygienist are counted on during all phases of a hazardous material emergency. The industrial hygienist is involved with contingency planning for potential incidents and recognizing, evaluating, and controlling health and safety risks during the incident. The industrial hygienist also helps develop the cleanup site safety plan and contributes to the incident termination process, where a critique of the response and cleanup is conducted, and final documentation is made. Ideally, it is the industrial hygienist's responsibility as an expert and a teacher to help others identify, recognize, and understand the cause and effect of hazardous materials incidents so they can be prevented in the first place. However, whenever hazardous materials are transported or used, a spill or release could occur. One needs to be prepared for unexpected incidents. Preparedness is as important as prevention; it is not possible to prevent all accidents, no matter what precautions are taken. Hazardous material emergencies were etched into the public's consciousness by two major catastrophes in the 1980s, the Bhopal, India methyl isocyanate release, and the Exxon Valdez oil spill. Both disasters resulted in major changes in U.S. industry practices and have put a new emphasis on the industrial hygiene profession for all aspects of hazardous materials management. In India, a catastrophic release of methyl isocyanate, a highly poisonous and irritating vapor, rapidly killed or injured thousands of people living near the Union Carbide facility. Images quickly flashed to the rest of the world showing the devastating results of an uncontrolled release from a chemical process that produced a deadly vapor cloud. As soon as it became clear how quickly so many lives could be lost, much of the industrialized world launched top-priority programs to examine its own chemical manufacturing processes to assess whether that kind of event could ever happen again, and to work to prevent it. The Exxon Valdez oil spill took many weeks to develop fully, which gave the public time to develop a perception that the spill was of a magnitude that seemed beyond effective control, and the size of the area eventually touched by the spilled oil was astonishingly large. As a result of this incident, public attention became focused on the potential risks of hazardous materials transportation, from crude oil to just about any transported chemical. Prevention and control regulations can only go so far in preventing chemical release incidents. As long as transport vehicles are operated by human beings that must navigate around environmental factors out of their control, it is likely major incidents will occur for years to come. Keywords: Regulatory framework; HAZWOPER; Planning; Coordination; Emergency response; Oil spills; Hazard evaluation; Personal protective equipment; Decontamination; Emergency response monitoring; Assistance resources

Quality assurance activities in Germany have a long tradition of being oriented to structural quality. For many years quality assurance in hospitals was limited to pathologist's examinations and ward rounds. The separation of health care services into in-patient and out-patient sectors has made it difficult to introduce a total quality management system. After passage of a revised social security act on quality assurance, physicians' organizations started quality management projects, which for the most part are still in the pilot phase. Many institutions and commissions are trying to develop quality assurance activities focusing on formulating practice guidelines. However, in order to make quality management a truly vital part of health care in Germany, adequate computerized documentation systems will need to be introduced.

Quality Performance of Screening Colonoscopy in Germany Berndt R. Birkner, Jorn Knopnadel, Lutz Altenhofen, Gerhard Brenner, Wolf Schmiegel, Meinhard Classen Introduction: In Germany enrolees of the statuatory health insurances are entitled to undergo a screening colonoscopy beginning with the age of 56 since October 1st 2002. Quality assurance issues are important, because healthy people are exposed to a substantial risk of adverse events. Only experienced endoscopists are allowed to perform the screening colonoscopy after approval. The minimum standards for approval are a license as internist or gastroenterologist and profound experiences in at least 200 total colonoscopies and 50 polypectomies performed during the last 24 months. A documentation form has to be filled out by the endoscopist for each procedure to evaluate quality performance. The forms have to be sent to the Central Research Institute of Ambulatory Health Care in Germany for data processing. Methods: The data of 303,052 documented screening colonoscopies, performed from January 03 to December 03, were analyzed. Main focus here was on a set of performance measures e.g. completeness, video documentation, polypectomies and complications. Results: Colonoscopies reached the cecum and ileum in 71.8% and 23.9%, but the completeness was documented by video printing in 96.0%. Polyps were found in 28.3 % consisting of adenomas in 17.7%. Size was differentiated in !5, 5-10, 11-30 and O30 mm, detected in 14.2%, 9.5%, 3.8% and 0.8%, respectively. In total 1264 (0.4%) adverse events were documented. No case fatality was reported. 78,697 (26%) polypectomies were carried out. Thereafter 732 (0.9%) bleedings and 86 perforations were noted immediately, resulting in surgery in 2.7% and 91.5%, respectively. There is a strong increasing risk of complications depending on polyp size (OR 6.5 for 11-30 mm and OR 9.5 for O30 mm) even after control for age. In 446 (0.1%) cases cardio-pulmonary adverse events occurred, with 357 (80.0 %) in combination with sedation. Conclusion: Screening colonoscopy seems to be safe with a high completion rate. Even if only polypectomies are taken into account, the bleeding and perforation rates seem to be lower in all age strata than with curative colonoscopies. Notable is the perforation rate without polypectomy, which occurred in 1 out 10,000 screening colonoscopy. Predominantly, sedation was associated with cardio-pulmonary adverse events. W1090 Colonoscopic Features of Graft-Versus-Host Disease After Allogeneic Bone Marrow Transplantation Jeong-Sik Byeon, Suk-Kyun Yang, Seung-Jae Myung, Ji Yoon Cho, Kyu-Jong Kim, Seong Soo Hong, Gin Hyug Lee, Hwoon-Yong Jung, Weon-Seon Hong, Jin-Ho Kim, Young Il Min Background: Graft-versus-host disease (GVHD) is a frequent cause of morbidity and mortality after allogeneic bone marrow transplantation (BMT) and often involves gastrointestinal tract. However, the colonoscopic findings of GVHD have not been described clearly. The purpose of this study was to analyze the endoscopic features and biopsy results of colorectal GVHD. Methods: We analyzed the endoscopic features, biopsy results, and clinical findings of 21 patients (M:F Z 9:12, 18-50 years) who underwent colonoscopy or sigmoidoscopy due to unexplained gastrointestinal symptoms after allogeneic BMT and were diagnosed with colorectal GVHD by the histologic evaluation of biopsy specimen. Results: The mean duration from BMT to the diagnosis of GVHD was 2.4i/41.1 months. Twelve patients complained of abdominal pain, 18 diarrhea, and 3 hematochezia. Twelve patients underwent colonoscopy and 9 sigmoidoscopy. The endoscopic findings were divided into 3 categories, which were (a) hyperemic type showing multiple, variable shaped, hyperemic patches, (b) irregular shallow ulcer type showing several, small, irregular, shallow ulcers, and (c) round ulcer type showing several, about 1-3 cm sized, round ulcers. Among 12 patients who underwent colonoscopy, 4 showed hyperemic type, 4 irregular shallow ulcer type, and 4 round ulcer type. Among 9 patients who underwent sigmoidoscopy, 7 were hyperemic type, 1 round ulcer type, and 1 showed normal finding. There was no difference in the distribution of hyperemia, irregular shallow ulcer, and round ulcer according to the terminal ileal and colorectal segments including cecum, ascending/transverse/ descending/sigmoid colon, and rectum. Fifty three (91.4%) of 58 biopsy specimen from each segments demonstrated the typical histologic features of GVHD. All 45 biopsy specimen (100.0%) from 45 hyperemic or ulcer lesions and 8 biopsy specimen (61.5%) from 13 grossly normal segments revealed the histologic findings of GVHD. Thirteen patients demonstrated the skin involvement of GVHD, 13 the hepatic involvement, and 8 both the skin and hepatic involvement. Three patients had only terminal ileal or colorectal GVHD without the skin or hepatic involvement. Conclusion: Colonoscopic features of GVHD may be categorized into hyperemic, irregular shallow ulcer, and round ulcer type. Histologic evaluation of biopsy specimen not only from grossly abnormal lesions but also from normal segments may increase the diagnostic yield.

In a joint retrospective study by 17 radiotherapy clinics in German-speaking countries the results of treatment of bronchial carcinoma after radiotherapy were analysed in 7503 cases. The age peak was between the 60th and 70th year. Squamous-cell carcinoma was the most frequent histological type, followed by anaplastic carcinoma, with adenocarcinoma being rare. There was a high proportion of histologically not clearly identified cases (27% in central and 35% in peripheral carcinomas). Survival rate at one year was 31% for central (3662 patients) and peripheral (961 patients) tumours, but only 2% at five years. Prognostically there was no difference between histological types and kind of radiotherapy or technique, but total dose affected survival rate. At a total dose of less than 5000 rd the survival rate at five years was minimal. The prognosis of combined surgical and radiotherapeutic measures was slightly better than with a radiotherapy alone, but results were unpredictable for the individual case. It is concluded that radiotherapy aiming at cure should be used in imoperable bronchial carcinoma if the tumour state and general condition of the patient appear to make a cure possible. But if this is not the case, radiotherapy should be used only palliatively, i.e. only to ameliorate symptoms.

Das seltene Krankheitsbild der leuco-erythroblastischen Anamie mit Myelosklerosis (Typ Vaughan) stellt ein klinisch scharf umrissenes Syndrom dar. Die Diagnose intra vitam gelingt bei Kenntnis der eigentumlichen Befunde im Rontgenbild, peripheren Blut, Knochenmark- und Milzpunktat. Hierbei kommt der Rontgenuntersuchung eine entscheidende Bedeutung zu. An 2 eigenen Beobachtungen wird die charakteristische Symptomatik im einzelnen aufgezeigt und besonders auf die Moglichkeiten hingewiesen, aus den rontgenologisch fasbaren Reaktionsformen des Knochengewebes Ruckschlusse auf den zugrundeliegenden Markprozes ziehen zu konnen. Es wird auf die Schwierigkeiten bei der pathogenetischen Ausdeutung der Erkrankung hingewiesen, bei der es sich am ehesten um eine koordinierte Storung der hamopoetischen und der knochenbildenden Funktion auf dem Boden einer Fehldifferenzierung der multipotenten reticularen Mesenchymzelle im Sinne einer polyblastischen Retotheliose handelt. The rare aspect of the leuco-erythroblastic anaemia with myelosclerosis (type Vaughan) presents a clinically sharp outlined syndroma. The diagnosis can be made intra vitam if one is familiar with the peculiar signs on the roentgenfilm, in the peripheral blood, puncture of bone marrow and spleen. The roentgenexamination is of essential importance. With the aid of two own observations the characteristic symptomatology is discussed in detail and specially the possibility is pointed at to draw conclusions from the roentgenologic forms of reaction of the osseous tissue on the basic marrow process. The difficulties of the pathogenetic interpretation of the disease are referred to which is a question of a coordinated disturbance of the hematopoietic and osteogenetic function on the basis of a faulty differentiation of the multipotent reticular mesenchym cell in the sense of a polyblastic retotheliosis. L'anemie leuco-erythroblastique avec myelosclerose (type Vaughan) est une affection rare correspondant a un syndrome bien defini. Le diagnostic clinique est possible si l'on tient compte de l'image radiologique, des frottis du sang, de la moelle et de la ponction de la rate. L'examen radiologique est decisif. 2 cas personnels presentent les symptomes cardinaux. La reaction du tissu osseux permet certaines conclusions quant a l'etat du tissu medullaire. L'interpretation pathogenetique est difficile, il s'agit, sembie-t-il, d'une atteinte simultanee des fonetions hemo- et osteeopoietique qu'on peut rapporter a un dereglement de la cellule mesenchymateuse reticulaire s'exprimant en une retotheliose polyblastique. El excepcional cuadro de la anemia leuco-eritroblastica con mielosclerosis (tipo Vaughan) representa un sindrome clinico netamente delimitado. El diagnostico en vida es factible conociendo las caracteristicas radiologicas de esta enfermedad, las del cuadro sanguineo y el resultado de la puncion de medula y bazo. El examen radiologico tiene, en este sentido, importancia decisiva. A base de dos observaciones propias se describe la caracteristica sintomatologia con todo detalle, senalandose, sobre todo, la posibilidad de deducir de las formas reaccionales del tejido oseo en el cuadro radiologico la presencia del proceso medular fundamental. Se senalan las dificultades que se oponen a la interpretacion patogenetica de esta enfermedad la quedebe imputarse, en primer termino, a un trastorno coordinado de la funcion hemopoyetica y osteoblastica como consecuencia de una deficiencia en la diferenciacion de la celula mesenquimatica reticular multipotencial en el sentido de una retoteliosis poliblastica.

To plot isodose curves in a tissue-equivalent phantom is a time consuming operation. This is particularly disturbing in practical work when the working out of an individual dosage is required which takes into account the particular anatomical conditions of the individual patient. An apparatus has, therefore, been constructed which autoraatically registers the dose distribution in any plane section through the isodose volume corresponding to a paaticular field. A description is presented of the technical conditions that raust be fulfilled by such a measuring apparatus in order to meet the requirements of radintion therapy. An account is given of the construction of the device and of the way in which measurements are carried out. Some examples illustrate the operation of the instrument. The apparatus can be used not only in deep-ray therapy but to record the dose for any field of irradiation for which the dose is constant over the time of the measurement. (auth)

In a joint retrospective study by 17 radiotherapy clinics in German-speaking countries the results of treatment of bronchial carcinoma after radiotherapy were analysed in 7503 cases. The age peak was between the 60th and 70th year. Squamous-cell carcinoma was the most frequent histological type, followed by anaplastic carcinoma, with adenocarcinoma being rare. There was a high proportion of histologically not clearly identified cases (27% in central and 35% in peripheral carcinomas). Survival rate at one year was 31% for central (3662 patients) and peripheral (961 patients) tumours, but only 2% at five years. Prognostically there was no difference between histological types and kind of radiotherapy or technique, but total dose affected survival rate. At a total dose of less than 5000 rd the survival rate at five years was minimal. The prognosis of combined surgical and radiotherapeutic measures was slightly better than with a radiotherapy alone, but results were unpredictable for the individual case. It is concluded that radiotherapy aiming at cure should be used in imoperable bronchial carcinoma if the tumour state and general condition of the patient appear to make a cure possible. But if this is not the case, radiotherapy should be used only palliatively, i.e. only to ameliorate symptoms.

Neither the physics nor the politics of respirator research can take place in a vacuum. Industry must be a party to setting research priorities and to the peer review of research growing out of these priorities. After all, we know where the utilization of respiratory protection is a necessary part of our manufacturing processes. But more important, it is our employees who must wear the fruits of your research and development efforts, and it is essential to us as employers that, when respirators are required, they afford equal protection to that of the best engineering, work practices, and administrative controls.

The investigation was designed to study plasma drug concentration and prolactin response determined by two different doses of haloperidol, a standard one and four-fold higher the other, and to explore the relationships between clinical effects and pharmacokinetic and physiological variables in psychotic patients. 24 psychotic patients received haloperidol during 40 consecutive days. During the first 10 days they received 0,25 mg/kg b.w. During the next 20 days they were given 1 mg/kg b.w. Finally they received 0,25 mg/kg b.w. during the last ten days. The patients were clinically assessed and plasma haloperidol and prolactin concentrations were determined on days 0, 5, 10, 20, 30 and 40. In the range of dose studied, the use of higher than conventional doses of haloperidol results in an increased concentration in the cellular site of action and in a more complete blockade of central dopamine receptors. Prolactin response was positive correlated with serum haloperidol concentration. Clinical remission was not direct correlated, neither with serum neuroleptic concentration nor with prolactin level. Those patients who reached higher levels of plasmatic neuroleptic and prolactin concentrations were more susceptible to develop severe extrapyramidal side-effects. Pharmacokinetic and pharmacodynamic monitoring of neuroleptic treatment could be useful to identify these patients.

The cost-effectiveness analysis method discussed compares the cost of various control strategies for achieving a desired level of exposure. Such analysis can provide management with additional data upon which to make decisions relative to exposure control programs. Cost-effectiveness analysis does not assess the benefit of the level to be achieved--such as an OSHA PEL or internal company standard--but the costs of achieving the level. The method utilizes discounted cash flow analysis on incremental control strategy investments and expenses to compare the costs associated with various achievable and effective exposure mitigation utilizing engineering, administrative, work practice, personal protection controls or a combination of such approaches for economic efficiency. To determine process-life costs of exposure control, the method evaluates capital investments, annual expenses, taxes, inflation, cost of money and revenues. An additional feature of the method is its ability to help fine tune investments for a given strategy maximizing the level of employee protection achieved while minimizing expenditures.