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ZusammenfassungEs stehen verschiedene alternative chirurgische Optionen zur Verfügung, um eine sekundäre Intraokularlinse (IOL) in Augen mit unzureichender Kapselunterstützung zu implantieren. Erfolgreiche Techniken umfassen die Implantation einer irisfixierten IOL (IFIOL), einer kammerwinkelgestützten Vorderkammerlinse (ACIOL) oder verschiedene Variationen zur Sklerafixierung (SFIOL). Jede dieser Methoden hat sich als sicher und effektiv erwiesen, weist jedoch verfahrensspezifische Einschränkungen auf. Jüngste Studien zeigen, dass die Entwicklung neuer chirurgischer Techniken diesen Patienten weiterhin sichere und reproduzierbare Behandlungsmöglichkeiten bietet. Obwohl die Implantation von sekundären IOLs ohne Kapselunterstützung von vielen Faktoren, einschließlich der Präferenz des Chirurgen, abhängt, sind nahtlose sklerafixierende Techniken für die chirurgische Gemeinschaft von wachsendem Interesse. Das Bestreben nach kürzeren und weniger traumatischen Operationen sowie nach reproduzierbaren und funktionell guten Ergebnissen, fördert dabei die Entwicklung von neuen Operationstechniken, Intraokularlinsen und Instrumenten. Diese Übersichtsarbeit gibt einen Einblick in alte und neue Behandlungsmethoden zur Korrektur von Aphakie mit sekundären Intraokularlinsen

Purpose To investigate the impact of large choroidal vessels (LCV) on Choriocapillaris (CC) flow deficit (FD) analyses with swept-source optical coherence tomography angiography (SS-OCTA) Design Prospective, cross-sectional study. Methods Macular 6x6mm SS-OCTA scans were obtained from intermediate age-related macular degeneration (iAMD) and healthy eyes. Images were captured and processed according to most common standards and analyzed for percentage of flow-deficits (FD%) within four 1x1mm squares at the corners of each image. Choroidal thickness (CT), iris color and refraction error were considered as potential influential factors for LCV visibility. A linear mixed model and logistic regression models were calculated for statistical evaluation. Results Sixty-nine iAMD and 49 age-matched healthy eyes were enrolled. LCV were visible in at least one sector in 52% of iAMD and 47% of healthy eyes. Within the iAMD group FD% were significantly lower in areas containing LCV (p = 0.0029). Increasing CT resulted in an odds ratio decrease of LCV (OR: 0.94, p Conclusions LCV can significantly affect CC FD analyses of SS-OCTA images. Their visibility is negatively associated with CT. The impact of LCV should be taken into account when performing CC FD assessments, especially in patients where reduced CT is to be expected and inclusion of affected areas should be considered carefully.

BACKROUND: Mechanical impairment of valve function by biofilms is considered to cause loss of function of voice prostheses in laryngectomized patients. Material deterioration and infiltrative growth of Candida associated biofilms have already been observed on Groningen Buttons. Goal of the study was the examination of biofilm formation and material damages on PROVOX ® 2 voice prostheses. METHODS: 20 PROVOX ® 2 voice prostheses were withdrawn from 17 laryngectomized patients due to aspiration (mean in-vivo time: 118 d, median 98 d). Microbial spectrum, colonization patterns and morphologies of prosthesis damage were assessed using standard microbiologic procedures and scanning electron microscopy. RESULTS: Biofilm with various growth patterns predominantly adhered to the esophageal parts of the prostheses. Microbiologic findings showed Candida species as main colonisers on esophageal surfaces. Different morphologies of surface alteration and material infiltration of the polymer material were identified on 8 prostheses with 35 d of in-vivo time minimum. CONCLUSION: Valve dysfunction of PROVOX ® 2 voice prostheses can be attributed to biofilm formation on esophageal surfaces and edges of the valve flap and seating. The identified morphologies of material damage and invasive growth indicate towards lytic processes of the polymer material due to Candida associated biofilms.

vorgelegt von Stefanie Reumüller Graz, Univ., Dipl.-Arb., 2014

Mechanical impairment of valve function by biofilms is considered to cause loss of function of voice prostheses in laryngectomized patients. Material deterioration and infiltrative growth of Candida associated biofilms have already been observed on Groningen Buttons. Goal of the study was the examination of biofilm formation and material damages on PROVOX2 voice prostheses.20 PROVOX2 voice prostheses were withdrawn from 17 laryngectomized patients due to aspiration (mean in-vivo time: 118 d, median 98 d). Microbial spectrum, colonization patterns and morphologies of prosthesis damage were assessed using standard microbiologic procedures and scanning electron microscopy.Biofilm with various growth patterns predominantly adhered to the esophageal parts of the prostheses. Microbiologic findings showed Candida species as main colonisers on esophageal surfaces. Different morphologies of surface alteration and material infiltration of the polymer material were identified on 8 prostheses with 35 d of in-vivo time minimum.Valve dysfunction of PROVOX2 voice prostheses can be attributed to biofilm formation on esophageal surfaces and edges of the valve flap and seating. The identified morphologies of material damage and invasive growth indicate towards lytic processes of the polymer material due to Candida associated biofilms.

Wenn die Qualität der Verstehensleistung bzw. der Verstehenstiefe in der Schule dadurch definiert wird, dass die uns umgebenden Dinge ihrer lebensweltlichen Bedeutungshöfe entkleidet werden, um sie zu einem Abstraktum der modernen Wissenschaft zu machen, dann ist nicht nur von einem Gewinn, sondern auch von einem Verlust zu sprechen. Schüler/innen lernen schnell, dass die Anstrengung und die Produktivität des Lernens im Erarbeiten von allgemeinen Zusammenhängen liegt oder dass die Theoretisierung eines Phänomens eine Leistung ist, dass Abstraktionen und Strukturbildungen Leistungen sind. Es ist aber kaum ein Bewusstsein vorhanden, dass das Abtasten einer Oberfläche, das Studieren eines Bildes, das Eindringen in den individuellen Fall, das sich Einlassen auf das Wahrnehmbare, das Artikulieren auf Grund von Empathiefähigkeit auch Leistungen sind. Diese Prozesse und Qualitäten gehören auch kultiviert. Das ist das Anliegen der neuen Lernkulturen. Ihre Leistung liegt in der Zusammenschau beider Denkansätze. In der Arbeit werden Schulstandorte aufgespürt, die diese Lernarten pflegen. Das mehrdimensionale Tun und Handeln wird beschrieben und analysiert. Auf die unterprivilegierten Lernpotentiale von Schulen im Denken, Erfahren, Erleben, Gestalten und Handeln wird dabei aufmerksam gemacht. Vor diesem Hintergrund baut sich die Theorie neuer Lernkulturen auf., In the school context, the quality of understanding is defined and characterised by the fact that the word around us is deprived of its wealth of connotations, shades of meaning and its variety of possible interpretations and thus is turned into abstract scientific notions. Depending on ones perspective, this can be seen as a gain or as a loss. Very early in the course of their school career pupils realise that one of the main aims of learning is to figure out general patterns or interrelations and that it is important to work towards general structures, theories and abstractions. Very rarely processes like exploring the surface of a phenomenon, studying a picture in detail, analysing a case in depth or working with all ones senses are appreciated as genuine achievements or real efforts. However, these are exactly the processes and qualities that should also be furthered and supported. Combining both approaches, i.e. the analytical and the holistic one, is the main concern of what could be called New Learning Cultures. In this paper schools who try to realise these principles and the way they work are described and analysed in detail. The paper also tries to show ways of activating neglected learning potentials with regard to thinking, creativity, first-hand experience and learning by doing. These approaches form the basis of a theory of New Learning Cultures., Alfred Reumüller, Klagenfurt, Univ., Diss., 2004