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of the manuscript Contrail ice nucleation and ice crystal loss during the vortex phase control ice crystal numbers in young contrails and can have a strong impact on the properties and the life cycle of contrail cirrus. For current soot number emissions, ice nucleation is controlled by the number of emitted soot particles and atmospheric conditions while ice crystal loss during the vortex phase depends predominantly on the nucleated ice crystal numbers and the relative humidity over ice. Initial ice crystal numbers after the vortex phase are close to the emitted soot particle number only for very low ambient temperatures (< 210 K) and for highly ice-supersaturated conditions. Higher temperatures and lower relative humidities lead to significantly decreased ice crystal numbers. Global climate model simulations show that ice crystal numbers per fuel mass of young contrails are on average significantly lower than the soot number emission index. In the extratropics this is caused by a high ice crystal loss during the vortex phase and in the subtropics, tropics and at lower flight levels by decreased ice nucleation. Simulated ice crystal numbers per newly formed contrail length agree well with in-situ measurements over Central Europe within the variability of present-day soot number emissions. Our estimated global mean contrail cirrus radiative forcing (gRF) for the year 2006 is 44 mWm-2, around 22% lower than estimated in a previous study. When reducing soot number emissions, the gRF decreases slightly weaker than proposed by a recent study due to the ice crystal loss during the vortex phase.

Unconventional superconductivity in non-centrosymmetric superconductors has attracted a considerable amount of attention. While several lanthanide-based materials have been reported previously, the number of actinide-based systems remains small. In this work, we present the discovery of a novel cubic complex non-centrosymmetric superconductor \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {Th}}_4{\text {Be}}_{{33}}{\text {Pt}}_{{16}}$$\end{document}Th4Be33Pt16 (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$I{\bar{4}}3d$$\end{document}I4¯3d space group). This intermetallic cage compound displays superconductivity below \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$T_{\text {c}} = 0.90 \pm 0.04$$\end{document}Tc=0.90±0.04 K, as evidenced by specific heat and resistivity data. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {Th}}_4{\text {Be}}_{{33}}{\text {Pt}}_{{16}}$$\end{document}Th4Be33Pt16 is a type-II superconductor, which has an upper critical field \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {H}}_{{\text {c}}2} = 0.27$$\end{document}Hc2=0.27 T and a moderate Sommerfeld coefficient \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\gamma _{\text {n}} = 16.3 \pm 0.8$$\end{document}γn=16.3±0.8 mJ \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {mol}}^{-1}_{\text {Th}}$$\end{document}molTh-1 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {K}}^{-2}$$\end{document}K-2. A non-zero density of states at the Fermi level is evident from metallic behavior in the normal state, as well as from electronic band structure calculations. The isostructural \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {U}}_4{\text {Be}}_{{33}}{\text {Pt}}_{{16}}$$\end{document}U4Be33Pt16 compound is a paramagnet with a moderately enhanced electronic mass, as indicated by the electronic specific heat coefficient \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\gamma _{\text {n}} = 200$$\end{document}γn=200 mJ \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {mol}}^{-1}_{\text {U}}$$\end{document}molU-1 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {K}}^{-2}$$\end{document}K-2 and Kadowaki–Woods ratio \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$A/\gamma ^2 = 1.1 \times 10^{-5}$$\end{document}A/γ2=1.1×10-5 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\upmu $$\end{document}μ \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\Omega $$\end{document}Ω cm \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {K}}^2$$\end{document}K2 \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {mol}}_{\text {U}}^2$$\end{document}molU2 (mJ)\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$^{-2}$$\end{document}-2. Both \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {Th}}_4{\text {Be}}_{{33}}{\text {Pt}}_{{16}}$$\end{document}Th4Be33Pt16 and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\text {U}}_4{\text {Be}}_{{33}}{\text {Pt}}_{{16}}$$\end{document}U4Be33Pt16 are crystallographically complex, each hosting 212 atoms per unit cell.

The notion of a simple ordered state implies homogeneity. If the order is established by a broken symmetry, elementary Landau theory of phase transitions shows that only one symmetry mode describes this state. Precisely at points of phase coexistence domain states formed of large regions of different phases can be stabilized by long range interactions. In uniaxial antiferromagnets the so-called metamagnetism is an example of such a behavior, when an antiferromagnetic and field-induced spin-polarized paramagnetic/ferromagnetic state co-exist at a jump-like transition in the magnetic phase diagram. Here, combining experiment with theoretical analysis, we show that a different type of mixed state between antiferromagnetism and ferromagnetism can be created in certain acentric materials. In the small-angle neutron scattering experiments we observe a field-driven spin-state in the layered antiferromagnet Ca3Ru2O7, which is modulated on a scale between 8 and 20 nm and has both antiferromagnetic and ferromagnetic parts. We call this state a metamagnetic texture and explain its appearance by the chiral twisting effects of the asymmetric Dzyaloshinskii-Moriya (DM) exchange. The observation can be understood as an extraordinary coexistence, in one thermodynamic state, of spin orders belonging to different symmetries. Experimentally, the complex nature of this metamagnetic state is demonstrated by measurements of anomalies in electronic transport which reflect the spin-polarization in the metamagnetic texture, determination of the magnetic orbital moments, which supports the existence of strong spin-orbit effects, a pre-requisite for the mechanism of twisted magnetic states in this material., Comment: Supplementary materials included

Korrektur zu 10.1038/s41375-020-0826-9

The intermetallic compounds YbAu{sub x}Ga{sub 2-x} (0.26

A new cationic clathrate I Si(46-x)P(x)Te(y) (6.6(1) < or = y < or = 7.5(1), x < or = 2y at 1375 K) was synthesized from the elements and characterized by X-ray powder diffraction, thermal analysis, scanning electron microscopy, wavelength dispersive X-ray spectroscopy (WDXS), neutron powder diffraction, and (31)P NMR spectroscopy. The thermal behaviors of the magnetic susceptibility and resistivity were investigated as well. Si(46-x)P(x)Te(y) reveals a wide homogeneity range due to the presence of vacancies in the tellurium guest positions inside the smaller cage of the clathrate I structure. The vacancy ordering in the structure of Si(46-x)P(x)Te(y) causes the change of space group from Pm3n (ideal clathrate I) to Pm3 accompanied by the redistribution of P and Si atoms over different framework positions. Neutron powder diffraction confirmed that P atoms preferably form a cage around the vacancy-containing tellurium guest position. Additionally, (31)P NMR spin-spin relaxation experiments revealed the presence of sites with different coordination of phosphorus atoms. Precise determination of the composition of Si(46-x)P(x)Te(y) by WDXS showed slight but noticeable deviation (x < or = 2y) of phosphorus content from the Zintl counting scheme (x = 2y). The compound is diamagnetic while resistivity measurements show activated behavior or that of heavily doped semiconductors. Thermal analysis revealed high stability of the investigated clathrate: Si(46-x)P(x)Te(y) melts incongruently at approximately 1460 K in vacuum and is stable in air against oxidation up to 1295 K.

Death certificates for all clinics of the University of Heidelberg are centrally filled in at the University Pathology Institute. The certificate which accompanies the body gives the information for the official death certificate. There were 6263 autopsies between 1974 and 1978. The entry in the death certificate was compared with the complete morbid-anatomical diagnosis. Sensitivity and positive correctness showed many errors, the proportion of false-negative diagnoses being nearly three times higher than false-positive ones.

Background. The aim of this study was an improvement in patient comfort, reduction of anaesthesia costs and room contamination by the use of propofol for adenoidectomy. Methods. A total of 103 infants (aged 1 -5 years) undergoing elective adenoidectomy were randomized for anaesthesia with sevoflurane-nitrous oxide/oxygen (group 1), sevoflurane-air/alfentanil (group 2), alfentanil-propofol under induction with sevoflurane (group 3) or alfentanil-propofol (group 4). Results. Using propofol, postoperative agitation and emesis were significantly less and the anaesthesia costs as well as the need for analgesics was reduced compared to inhalative anaesthesia. Conclusions. The use of propofol for preschool children undergoing ear, nose and throat (ENT) surgery seems to be advantageous because of less postoperative agitation, emesis and costs.

Injection-induced pain during induction of anaesthesia can result in patient's discomfort. This can prevent the use of propofol-anaesthesia in paediatric patients. Because of the high incidence of pain on injection with propofol numerous interventions have been tested to prevent this pain including the use of different drugs and physical measures as well as the combination of methods. The use of a single intervention is not as effective as the combination of different preventive measures. Thus the additional application of a venous tourniquet improves the pain reducing effect if drugs with peripheral mechanism of action are used for prevention of pain. Injection of lidocaine with a rubber tourniquet before the propofol injection is recommended as best effective method. In any case a propofol-MCT/LCT-Emulsion should be used for propofol-anaesthesia. Additionally a multimodal strategy that is adapted to the daily clinical practice seems to be convenient. That means, for general anaesthesia opioids or ketamine and for sedation a sub-anaesthetic dose of thiopental can be used for effective prevention of pain. If the prevention of nausea and emesis is intended, antiemetics that are appropriate for prevention of injection pain should be given. For paediatric anaesthesia the application of EMLA-cream seems to be suitable, because it alleviates the pain during venous cannulation at the same time. Although a painfree propofol injection is not possible with every prevention strategy there exist a wide range of effective interventions to prevent pain on injection with propofol. This article reviews methods that have been investigated and established to minimise the incidence of pain.

The ternary phase Yb4Ni10+xGa21−x has been synthesised from the elements by high frequency melting in argon atmosphere. The homogeneity region has been established from X-ray powder data and confirmed by EDX analysis for 0.3≤x≤1. The crystal structure of Yb4Ni10+xGa21−x has been estimated from X-ray single crystal data: space group C2/m (no. 12), Z=2, a=20.6815(9) A, b=4.0560(4) A, c=15.3520(7) A, β=124.800(3)°, R(F)=0.023 for 1701 symmetry independent reflections with F(hkl)>4σ(F). A special feature of the structure is the local disorder within the gallium/nickel network. Neglecting atomic disorder in the region of the Ga9 and Ga11 positions, the Yb4Ni10+xGa21−x structure is an occupation variant of the Ho4Ni10Ga21 type with nickel atoms partially replacing the Ga atoms in the 2d sites at the centers of distorted icosahedra. From magnetic susceptibility and from LIII-XAS spectra, the valence state of ytterbium is near 3+.

Background/aims: Periodontal infections with Actinobacillus actinomycetemcomitans seem to be refractory to conventional therapy. The aim of the present study was to test the in vitro susceptibilities of A. actinomycetemcomitans strains to a panel of seven orally administrable antibiotics. Methods: A total of 60 isolates of A. actinomycetemcomitans recovered from 43 individuals with gingivitis or periodontitis were tested. In addition, laboratory strains UP-6 and JP2 were analysed. The E-test was employed in order to determine minimal inhibitory concentrations (MIC) of antibiotics ampicillin/sulbactam, roxithromycin, azithromycin, doxycycline, metronidazole, ciprofloxacin, and moxifloxacin. Results:A. actinomycetemcomitans was highly susceptible to both fluoro-quinolones (MIC90 of 0.006 µg/mL of ciprofloxacin and 0.032 µg/mL of moxifloxacin). Good susceptibilities were found for ampicillin/sulbactam and doxycycline (MIC90 of 0.75 µg/mL and 1 µg/mL, respectively), and moderate susceptibilities for azithromycin (MIC90 of 3 µg/mL). Most strains were resistant to metronidazole and roxithromycin. Cluster analysis revealed two larger clusters of A. actinomycetemcomitans strains with the smaller cluster assembling isolates with significantly higher MICs of most antibiotics. Conclusions: Due to reported favourable pharmacokinetics, the fluoro-quinolone moxifloxacin appeared to be a promising candidate for adjunctive systemic antibiotic therapy in periodontal infections with A. actinomycetemcomitans.

A very low birth weight neonate (1.2 kg) with total anomalous pulmonary venous connection and obstructed infracardiac pulmonary venous drainage was treated by stenting of the ductus venosus via a transjugular approach. With one reintervention to dilate an in-stent stenosis, the palliative stented situation stabilized the patient for as long as three months until definitive surgical correction at a weight of 2 kg. © 2014 Wiley Periodicals, Inc.

The structure ofCo2Al5(hP28,P63/mmc) was refined by means of Rietveld method. The shortest Co–Al distance amounts 2.338 Å.Co2Al5shows a homogeneity range betweenCo29Al71andCo27.5Al72.5at 1125 K. The concentration dependence of lattice parameters was also measured. The axial ratioc/aincreases with increasing mole fraction of aluminum.

The crystal structure of the ternary Co2NiAl9(Y2phase in the Co–Ni–Al system) has been solved by single crystal methods. Despite the expectation, the Y2structure cannot be considered as a possible approximative structure for decagonal/icosahedral phases because of the small size of the structural segments with pentagonal antiprisms and of the absence of atoms with icosahedral atomic environment. An alternative description using only transition metal polyhedrons is discussed.

The crystal structures of IrAl2.75 (“Ir2Al5”) and RhAl2.63 (“Rh2Al5”) phases have been studied with single crystal methods: space group P23, IrAl2.75, a = 7.674(1) Å, Z = 8, RF = 0.053 (457 hkl, 29 parameters) and RhAl2.63, a = 7.6692(1) Å, RF = 0.042 (684 hkl, 29 parameters). The unit cell contains three transition metal sites and five aluminum sites. Most aluminum sites reveal strong defects in the occupations, some of them are described as being split. The overall number of atoms in the unit cell is 30(1) for IrAl2.75 and 29.0(3) for RhAl2.63. Ordering and full occupation lead either to the AuZn3 (space group Pm[unk]n) or to the hypothetical “Ir4Al13” structure (space group Pm[unk]).

A significant feature for the atomic structure of the intermetallic compounds Co2Al5 (hP28), monoclinic m-Co4Al13(mC(102-7.2) [notation according to Parthé etal. (1993)] and orthorhombic o-Co4Al13 (oP102) is the occurring of the filled pentagonal channels. Least-square refined lattice parameters as well as powder diffraction data are reported for these homeotypic phases.

Diiron pentaaluminide, Fe 2 Al 5 , M r =268.8, orthorhombic, Cmcm (No. 63), a=7.6559(8), b=6.4154(6), c=4.2184 (4) A, V=207. 19 (6) A 3 , Z=2, D x =4.23 (2), D m =4.20 (1) Mg m -3 , Mo Kα radiation, μ=8.2 mm -1 , F(000)=249.6, T=293 K, R=0.0229, wR=0.0270 for 137 unique reflections. The refined structure differs from the approximate structure proposed previously by an additional partially occupied atomic position

The intermetallic compounds YbAu{sub x}Ga{sub 2-x} (0.26

A new cationic clathrate I Si(46-x)P(x)Te(y) (6.6(1) < or = y < or = 7.5(1), x < or = 2y at 1375 K) was synthesized from the elements and characterized by X-ray powder diffraction, thermal analysis, scanning electron microscopy, wavelength dispersive X-ray spectroscopy (WDXS), neutron powder diffraction, and (31)P NMR spectroscopy. The thermal behaviors of the magnetic susceptibility and resistivity were investigated as well. Si(46-x)P(x)Te(y) reveals a wide homogeneity range due to the presence of vacancies in the tellurium guest positions inside the smaller cage of the clathrate I structure. The vacancy ordering in the structure of Si(46-x)P(x)Te(y) causes the change of space group from Pm3n (ideal clathrate I) to Pm3 accompanied by the redistribution of P and Si atoms over different framework positions. Neutron powder diffraction confirmed that P atoms preferably form a cage around the vacancy-containing tellurium guest position. Additionally, (31)P NMR spin-spin relaxation experiments revealed the presence of sites with different coordination of phosphorus atoms. Precise determination of the composition of Si(46-x)P(x)Te(y) by WDXS showed slight but noticeable deviation (x < or = 2y) of phosphorus content from the Zintl counting scheme (x = 2y). The compound is diamagnetic while resistivity measurements show activated behavior or that of heavily doped semiconductors. Thermal analysis revealed high stability of the investigated clathrate: Si(46-x)P(x)Te(y) melts incongruently at approximately 1460 K in vacuum and is stable in air against oxidation up to 1295 K.

Optical investigations are presented of the filled skutterudites AFe4Sb12 with divalent cations A=Yb, Ca, Ba. For each of these compounds a very similar pseudogap structure in the optical conductivity develops in the far-infrared spectral region at temperatures below 90 K. Highly accurate local-density approximation electronic band structure calculations can consistently explain the origin of the pseudogap structure generated largely by transition metal 3d states. In particular, a 4f-conduction electron hybridization or strong correlations can be ruled out as origin for the pseudogap.

Periodontal infections with Actinobacillus actinomycetemcomitans seem to be refractory to conventional therapy. The aim of the present study was to test the in vitro susceptibilities of A. actinomycetemcomitans strains to a panel of seven orally administrable antibiotics.A total of 60 isolates of A. actinomycetemcomitans recovered from 43 individuals with gingivitis or periodontitis were tested. In addition, laboratory strains UP-6 and JP2 were analysed. The E-test was employed in order to determine minimal inhibitory concentrations (MIC) of antibiotics ampicillin/sulbactam, roxithromycin, azithromycin, doxycycline, metronidazole, ciprofloxacin, and moxifloxacin.A. actinomycetemcomitans was highly susceptible to both fluoro-quinolones (MIC90 of 0.006 microgram/mL of ciprofloxacin and 0.032 microgram/mL of moxifloxacin). Good susceptibilities were found for ampicillin/sulbactam and doxycycline (MIC90 of 0.75 microgram/mL and 1 microgram/mL, respectively), and moderate susceptibilities for azithromycin (MIC90 of 3 microgram/mL). Most strains were resistant to metronidazole and roxithromycin. Cluster analysis revealed two larger clusters of A. actinomycetemcomitans strains with the smaller cluster assembling isolates with significantly higher MICs of most antibiotics.Due to reported favourable pharmacokinetics, the fluoro-quinolone moxifloxacin appeared to be a promising candidate for adjunctive systemic antibiotic therapy in periodontal infections with A. actinomycetemcomitans.

Three cases of latex anaphylaxis occurring during surgery are reported. Sudden cardiorespiratory collapse 40 to 90 minutes after induction of anaesthesia was treated with oxygen, crystalloid solution, adrenaline and methylprednisolone. Laboratory findings showed markedly elevated antibodies against latex postoperatively. All three patients had anorectal malformations. As children with malformations have to be operated on in early childhood, they have a high risk of developing antibodies against latex. Primary prophylaxis requires a general avoidance of latex products in children with malformations from the time of birth on.

There is a controversy about the concentration of topical phenylephrine recommended for diagnostic or therapeutic mydriasis. Phenylephrine 10% leads to a faster and more pronounced mydriasis but cardio-vascular side-effects like hypertension and arrhythmia have been reported. A maximal pupillary dilatation is a prerequisite for successful cataract surgery. The aim of this study was to evaluate the risk-benefit ratio of phenylephrine 10% in comparison to 5% in the daily practice of the cataract-surgery unit in our clinic by clinical assessment and monitoring of biochemical stress parameters.30 informed and consenting patients were randomly allocated to 2 groups of equal size. After a single application of 2 drops of phenylephrine 5% in group 1 and 10% in group 2 respectively and 1 drops of cyclopentolate 1% with neutral pupil (time 0), an ECG was recorded and blood pressure, pulse, oxygen-saturation and pupil size were measured. Simultaneously a blood-sample was taken and the serum-catecholamines adrenaline and noradrenaline were determined by HPLC (High Pressure Liquid Chromatography). These measurements were repeated after 5, 10 and 30 minutes.The mean pupil area after 30 minutes in group 1 was 31.97 (+/- 0.43) mm2 compared to 45.72 (+/- 0.39) mm2 in group 2. Our data showed no other significant variation between the groups: neither clinical monitoring nor catecholamine measurements showed concentration-dependent patterns in blood pressure development or serum levels. No systemic cardiovascular effects were observed.These results demonstrate that a controlled application of phenylephrine 10%--under observation of contraindications--yields no increased risk for the occurrence of cardio-vascular side-effects in comparison with phenylephrine 5%. Therefore, we recommend the use of phenylephrine 10% in the described dosage as routine medication for cataract surgery.

Nontuberculous mycobacteriosis due to M. smegmatis is a rarity. We report on the case of a 51 year old male HIV-seronegative patient without predisposing bronchopulmonary disease, but with a state after gastrectomy and splenectomy who developed unproductive cough, night sweat and weight loss. The chest radiograph and thoracic CT showed wide-spread bilateral patchy infiltrations. Histological examination of transbronchial biopsies revealed chronic carnificating pneumonia. A perhoracic fine-needle biopsy showed caseating epitheloid cell granulomas with acid fast bacilli. These were identified as M. smegmatis by PCR with subsequent sequencing. Acid fast bacilli could not be detected microscopically neither in sputum nor in bronchial secretions, however M. smegmatis has been repeatedly detected by culture in these materials. In neither material tubercle bacilli have been detected by nucleic acid amplification (NAT) or culture. Immunologic investigations revealed a reduced number of CD4+ lymphocytes and a reduction of interferon alpha- and -gamma-synthesis by peripheral blood mononuclear cells. Treatment with Rifabutin, Ethambutol, Clarithromycin and Ofloxacin resulted in complete clinical and roentgenological resolution.

The unwanted side effects of muscle relaxants used for anaesthesia in the newborn and infants resulted in a search for alternatives to atraumatic intubation (IN). The study was aimed to investigate conditions of intubation, time of intubation as well as changes in systolic, mean and diastolic blood pressure (RRs/RRm/RRd) and heart rate (HR) under the use of propofol (P) after narcosis induction by mask.The study was approved by the local ethics committee. The data was analysed from 100 infants aged between 4 days and 56 weeks (weight 2110-9230 g) in the ASA I and II groups (Group [Gr] A and B both with 50 patients). In both groups induction was performed inhalationally with halothane (1.5-2.0 vol%) and pure oxygen. After that propofol for intubation was applied in a dose of 2 mg/kg i.v. In Gr A blood pressure and heart rate were registered at three measuring points (MP): MP 1 = before P administration, MP 2 = after P, MP 3 = following intubation; in Gr B at MP 1 and MP 3. Additionally in Gr B the intubation time was recorded in seconds (t1 = time after P administration to beginning of IN, t2 = time after P administration to the end of the IN, t3 = t2-t1). In both groups the conditions of intubation were assessed (score 1--excellent, 2--good, 3--bad, 4--impossible intubation).The means of RRs/RRm/RRd/HR varied in Gr A at MP 2 by -11.20*/-9.18*/-8.58*/-3.52 mmHg/bpm and at MP 3 by -2.74/-2.26/-2.04/+5.46 mmHg/bpm in comparison to MP 1 (p0.05 = significant*). Compared to MP 1 in Gr B the mean values of RRs/RRm/RRd/HR varied at MP 3 by -0.89/+0.50/-0.80/+4.20* mmHg/bpm. T1 (mean, SD) was 10.88 +/- 3.52 seconds (s), t2 26.22 +/- 6.12 s, and t3 was therefore 15.78 +/- 6.28 s. Conditions of intubation were found to be excellent or good in both groups (Gr A and B [100 patients]: score 1 = 95x = 95%, score 2 = 5x = 5%).In the observation period, changes in heart rate stayed in the range of reference. In our opinion the excellent and good conditions for intubation, as well as the ultrashort drug-onset and intubation time demonstrate the good characteristics afforded by propofol to perform intubation in infancy.

In this study, the risk of iodine-induced thyrotoxicosis in unselected patients from an iodine-deficient area was investigated. The patients were consecutively enrolled. Thyroid hormone values and urinary iodine excretion were determined before, as well as 1, 4 and 12 weeks after iodine contamination by coronary angiography. Two of 788 unselected patients developed hyperthyroidism within 12 weeks. The two patients did not belong to a risk group for iodine-induced thyrotoxicosis (i.e. old people, patients with goiter or possible thyroid autonomy, low TSH). Both patients had normal TSH levels at baseline and ultrasound of the thyroid was without evidence of nodules. The study shows that in euthyroid unselected patients from an iodine-deficient area short-term iodine contamination by contrast media rarely leads to hyperthyroidism. On account of these facts, prophylactic therapy, e.g. by perchlorate or thiamazole, is not generally recommended, because the risk of side-effects is perhaps even greater than the risk of iodine-induced thyrotoxicosis.