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Die Pravention von Infektionskrankheiten im Krankenhaus ist ein klassisches Kooperationsfeld von Arbeitsmedizin und Krankenhaushygiene. Bei Norovirusinfektionen ist haufig auch das Personal betroffen. Um den Status quo der Zusammenarbeit und die Zufriedenheit damit zu quantifizieren, wurde im September 2016 eine Befragung von Betriebsarzten (BA) auf einer Fortbildungsveranstaltung durchgefuhrt. Der zweiseitige Fragebogen wurde an rund 150 BA verteilt. Erfragt wurden u. a. der Informationsstand zu Norovirusausbruchen, die Einbindung in das Ausbruchsmanagement und die Beurteilung der Zusammenarbeit mit dem Hygienefachpersonal. Der Fragebogenrucklauf (n = 55) betrug 37 %. N = 53 mit Krankenhausbezug wurden ausgewertet. Fast alle Befragten wussten von mindestens einem Norovirusausbruch in den letzten 5 Jahren. Die Halfte der BA wird „regelmasig“ uber grosere Ausbruche informiert; 31 % werden in das Ausbruchsmanagement eingebunden; 35 % haben Kenntnis von der Anzahl betroffener Patienten und 45 % von erkrankten Mitarbeitern (ubrige: „unregelmasig“ oder „nie“). Wahrend 90 % der BA die Zusammenarbeit mit der Krankenhaushygiene im Allgemeinen als „sehr“ oder „eher gut“ bewerteten, galt das signifikant weniger fur die Zusammenarbeit bei Norovirusausbruchen (65 %). Rund ein Drittel wunschte eine bessere/schnellere Information zu den o. g. Aspekten. Die Befragung liefert Hinweise auf Kommunikationsdefizite zwischen Betriebsarzten und dem Hygienefachpersonal zu Norovirusausbruchen bei medizinischem Personal. Die hier vorgestellten Ergebnisse haben wegen der geringen Fallzahl und dem Bias durch die selektierte Stichprobe naturlich nur eingeschrankte Aussagekraft und sollten durch eine systematische Erhebung erganzt werden.

Sepsis in the early stage is a common disease in emergency medicine, and rapid diagnosis is essential. Our aim was to compare pathogen diagnosis using blood cultures (BC) and the multiplex polymerase chain reaction (PCR) test.Methods. At total of 211 patients admitted to the multidisciplinary emergency department of our university hospital between 2006 and 2009 with suspected severe infection from any origin were studied. Blood samples for BC (aerobic and anaerobic) and multiplex PCR were taken for identification of infectious microorganisms immediately after hospital admission. Results of the BC and PCR correlated with procalcitonin concentration (PCT) and clinical diagnosis of sepsis (≥2 positive SIRS criteria) as well as with severity of disease at admission and with clinical outcome measures.Results of the BC were available in 200 patients (94.8%) and PCR were available in 119 patients (56.3%), respectively. In total, 87 BC (43.5%) were positive and identified 94 pathogens. In 45 positive PCRs, 47 pathogens (37.8%) were found. Identical results were obtained in 81.4%. In addition, BC identified 9 Gram-positive and 3 Gram-negative bacteria, while PCR added 5 Gram-negative pathogens. Coagulase-negative staphylococci were detected in blood cultures only (n=20, 21.3%), whereas PCR identified significantly more Gram-negative bacteria than BC. In patients with positive PCR results, the PCT level was significantly higher than in patients with negative PCR (15.0±23.3 vs. 8.8±32.8 ng/ml, p0.001). This difference was not observed for BC (10.6±25.7 vs. 11.6±44.9 ng/ml, p=0.075). The APACHE II score correlated with PCR (19.2±9.1 vs. 15.8±8.9, p0.05) and was also higher in positive BC (18.7±8.7 vs. 14.4±8.0, p0.01). Positive PCR and BC were correlated with negative clinical outcomes (e.g., transfer to ICU, mechanical ventilation, renal replacement therapy, death).In patients admitted with suspected severe infection, a high percentage of positive BC and PCR were observed. Positive findings in the PCR correlate with elevated levels of PCT and high APACHE II scores.

Acyl-adenylates and acyl-CoA thioesters of bile acids (BAs) are highly electrophilic acyl-linked metabolites which can undergo transacylation reactions with amino and thiol groups of nucleophilic groups on acceptor molecules such as amino acids, peptides, and proteins. Here, non-enzymatic acylation at pH 7.4 of glycine, taurine, glutathione (GSH), and N-acetylcysteine (NAC) by cholyl-adenylate (CA-AMP) was compared with that mediated by cholyl-CoA thioester (CA-CoA) using a 1:1 mixture of stable isotopically labeled CA-AMP and unlabeled CA-CoA. The transacylation products of these substrates were analyzed by liquid chromatography/electrospray ionization linear ion-trap mass spectrometry in negative-ion detection mode. CA-AMP was more reactive than CA-CoA with the amino group of glycine or taurine than with the thiol group of GSH or NAC. In contrast, CA-CoA was more reactive than CA-AMP with the thiol group of GSH or NAC and was far less reactive with the amino group of glycine or taurine. These differences in the reactivity of CA-AMP as compared with that of CA-CoA towards amino and thiol groups may be attributed to the electrophilicity of the carbonyl carbon of these acyl-linked cholic acid metabolites and the nucleophilicity of the amino and thiol group in the bionucleophiles that were studied.

Previous work from this laboratory has reported the chemical synthesis of N-acetylcysteine (NAC) conjugates of natural bile acids (BAs) and shown that such novel conjugates can be formed in vivo in rats to which NAC has been administered. The subsequent fate of such novel conjugates is not known. One possible biotransformation is sulfation, a major pathway for BAs N-acylamidates in patients with cholestatic liver disease. Here, we report the chemical synthesis of the 3-sulfates of the S-acyl NAC conjugates of five natural BAs (cholic, chenodeoxycholic, deoxycholic, ursodeoxycholic, and lithocholic). We also measured the sulfation of N-acetylcysteine-natural bile acid (BA-NAC) conjugates when they were incubated with a rat liver cytosolic fraction. The chemical structures of the BA-NAC 3-sulfates were confirmed by proton nuclear magnetic resonance, as well as by means of electrospray ionization-linear ion trap mass spectrometry with negative-ion detection. Upon collision-induced dissociation of singly and doubly charged deprotonated molecules, structurally informative product ions were observed. Using a triple-stage quadrupole instrument, selected reaction monitoring analyses by monitoring characteristic transition ions allowed the achievement of a highly sensitive and specific assay. When BA-NACs were incubated with a rat liver cytosolic fraction to which 3'-phosphoadenosine 5'-phosphosulfate was added, sulfation occurred, but the dominant reaction was hydrolysis of the S-acyl linkage to form the unconjugated BAs. Subsequent sulfation occurred at C-3 on the unconjugated BAs that had been formed from the BA-NACs. Such sulfation was proportional to the hydrophobicity of the unconjugated bile acid. Thus, NAC conjugates of BAs as well as their C-3 sulfates if formed in vivo are rapidly hydrolyzed by cytosolic enzymes.

A Yagi–Uda directional antenna — the work horse of radiofrequency communications for more than 60 years — has now been demonstrated at visible wavelengths. An array of appropriately tuned nanoparticles replicate the reflecting and directing elements of the original design. Directional control of radiation from the nano-optical Yagi–Uda antenna was experimentally shown.

In 1991, 230 cementless total hip arthroplasties (THAs) with anatomical Stolzalpe-Buchner-Graf (SBG) stems were implanted in 230 patients at our hospital. Patients were examined retrospectively and consecutively 15 years after the operations.In total, 118 patients were available for follow-up (average 12.8 +/- 3.8 years postoperatively), with 44 examined clinically/radiologically at our hospital and 74 interviewed by telephone. Five THAs needed revision (stem explantation), three for aseptic loosening. Average patient age at the time of surgery was 61 years (27-91 years). For all THAs, we implanted ceramic-to-metal heads in combination with ultra-high molecular weight polyethylene inlay (ceramic/polyethylene and metal/polyethylene articulating components).The survival rate of the SBG stem was 98.13% (CI 94.32-99.39%) with aseptic loosening as the endpoint and 96.98% (CI 92.85-98.74%) with revision and stem explantation for any other reason as the endpoint. The average Harris Hip Score was 36.0 +/- 6.9 (range 22-45) preoperatively, increasing to 88.2 +/- 15.3 (30-100) for clinically evaluated patients and 80.3 +/- 11.3 (27-91) for telephone-interviewed patients at 15 years postoperatively. Osteolysis and radiolucent lines around the prosthetic stem were rarely observed (mainly at the proximal diaphysis).These follow-up results emphasize the excellent long-term outcomes associated with the SBG stem.

Reactive metabolic-modified proteins have been proposed to play an important role in the mechanism(s) of the hepatotoxicity and colon cancer of lithocholic acid (LCA). To identify cellular proteins chemically modified with LCA, we have generated a monoclonal antibody that recognizes the 3alpha-hydroxy-5beta-steroid moiety of LCA. The spleen cells from a BALB/c mouse, which was immunized with an immunogen in which the side chain of LCA was coupled to bovine serum albumin (BSA) via a succinic acid spacer, was fused with SP2/0 myeloma cells to generate antibody-secreting hybridoma clones. The resulting monoclonal antibody (gamma2b, kappa) was specific to LCA-N(alpha)-BOC-lysine as well as the amidated and nonamidated forms of LCA. The immunoblot enabled the detection of LCA residues anchored on BSA and lysozyme. The antibody will be useful for monitoring the generation, localization, and capture of proteins tagged with LCA, which may be the cause of LCA-induced toxicity.

Bile acids and bile alcohols in the form of their conjugates are amphipathic end products of cholesterol metabolism with multiple physiological functions. The great variety of bile acids and bile alcohols that are present in vertebrates are tabulated. Bile salts have an enterohepatic circulation resulting from efficient vectorial transport of bile salts through the hepatocyte and the ileal enterocyte; such transport leads to the accumulation of a pool of bile salts that cycles between the liver and intestine. Bile salt anions promote lipid absorption, enhance tryptic cleavage of dietary proteins, and have antimicrobial effects. Bile salts are signaling molecules, activating nuclear receptors in the hepatocyte and ileal enterocyte, as well as an increasing number of G-protein coupled receptors. Bile acids are used therapeutically to correct deficiency states, to decrease the cholesterol saturation of bile, or to decrease the cytotoxicity of retained bile acids in cholestatic liver disease.

Insbesondere Beschaftigte im Gesundheitsdienst und in Laboratorien sind dem Risiko berufsbedingter Infektionen ausgesetzt, aber auch das Personal in der Kinderbetreuung, in der Lebensmittelproduktion, im Forst- und Landwirtschaftsbereich sowie Beschaftigte in der Abfallentsorgung und in der Abwasserbehandlung. EG-Richtlinien sowie nationale deutsche Verordnungen und Empfehlungen dienen dem Zweck der Gefahrdungsbeurteilung, des Risikomanagements und der Pravention von Infektionen. In diesem Beitrag wird die derzeit ubliche Biostoffklassifikation vorgestellt. Seropravalenzdaten aus verschiedenen Bereichen des Arbeitslebens illustrieren das jeweilige Gefahrdungspotenzial. Abschliesend werden technische, organisatorische, personliche und immunologische Praventionsmasnahmen vorgestellt und diskutiert.

We report on a novel method for two-dimensional electrical mapping of neuronal activity using a 1 mm2 array of 16384 sensor field-effect transistors fabricated by an extended CMOS (complementary metal oxide silicon) technology. The contact from neurons to chip is made by an insulating oxide on the chip surface that provides a purely capacitive drive of the sensor transistors. As a test system for multi-transistor-array (MTA) recording we use cultured neurons from the pond snail. We present electrical maps of an individual neuron and of a small neuronal network at a resolution of 7.8 μm. MTA recording provides a tool for imaging the network dynamics of cultured nerve cells and brain slices for studies in neurobiology and biosensorics.

Background: We set out to determine whether intravenously administered cholylglycylaminofluorescein (CGF), a fluorescent bile acid, would enhance the visualization of the biliary tract and bile leaks in rabbits undergoing laparoscopic cholecystectomy (LC). Methods: CGF was infused at doses of 1, 5, and 10 mg/kg b.w. Biliary recovery was determined spectrophotometrically (six rabbits). For LC (seven rabbits), a blue (fluorescein) filter was attached to the light source, and a fluorescein-emission filter was attached to the charge coupled device (CCD) camera. The biliary tract and bile leak (made by incising the gallbladder) was observed under standard and fluorescent illumination. Results: Apple-green fluorescence appeared in 2 min and persisted for 30-60 min, enhancing visualization of bile duct anatomy as well as the bile leak. Biliary recovery of CGF at 90 min was high (86-96% of the infused dose). Conclusion: In rabbits, CGF is secreted quantitatively in bile, induces biliary fluorescence, and enhances visualization of the bile ducts and bile leaks when viewed with appropriate filters

Berichte uber 46 Falle nosokomialer Ubertragungen von Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) und HIV von infektiosem medizinischem Personal auf Patienten wurden zusammengestellt und analysiert. Die nosokomiale Ubertragung von HBV (40 Falle, 404 infizierte Patienten), HCV (4 Falle, 224 infizierte Patienten) und HIV (2 Falle, 7 infizierte Patienten) zeigt Parallelen auf. Die zahlenmasig umfassendsten Ubertragungsfalle (217 HCV-Infektionen durch einen Anaesthesist, 75 HBV-Ubertragungen durch einen EEG-Laborant) werden auf unzureichende Hygienemasnahmen zuruckgefuhrt (hier: i. v. Drogenkonsum). Bei Einhalten der ublichen Hygienemasnahmen besteht nur durch infektioses chirurgisches arztliches Personal ein Infektionsrisiko fur Patienten. Tatigkeitsbeschrankungen sollten nur nach Einzelfallprufung ausgesprochen werden. Haufig hat sich das betroffene Personal selbst an Patienten infiziert. Gerate und Arbeitsmethoden sollten regelmasig in Bezug auf Infektionsgefahrdung fur Personal und Patienten uberpruft werden.

In den USA (1991), Kanada (1998), im Vereinigten Konigreich (1993, 1994) und in Deutschland (1999) wurden Empfehlungen zur Durchfuhrung „gefahrgeneigter Tatigkeiten“ durch Hepatitis-B-Virus (HBV)-, Hepatitis-C-Virus (HCV)- und HIV-infektiose Personen veroffentlicht. In dieser Arbeit werden die Definitionen gefahrgeneigter Tatigkeiten, die Methoden zur Reduktion der Transmission von blutubertragenen Mikroorganismen, die Impf- und Testpolitik, die Bildung eines Expertengremiums und die Frage von Ruckschauuntersuchungen zusammengefast, die in diesen Regelungen enthalten sind.

Injection of electric field pulses of high intensity (kV/cm) and short duration (microsecond range) into a cell suspension results in a temporary increase of the membrane permeability due to a reversible electric breakdown of the cell membrane. Here we demonstrate that application of supercritical field pulses between 4. 5 and 8.1 kV/cm strength and 40 microsec duration induce typical features of apoptosis in Jurkat T-lymphoblasts and in HL-60 cells including DNA fragmentation and cleavage of the poly(ADP ribose) polymerase. Apoptosis induction did not depend on the presence of any particular electrolyte in the extracellular medium. However, no apoptosis was observed in solutions without a minimum amount of salt. Apoptotic DNA fragmentation was prevented by the caspase inhibitor zVAD.

We postulated that coadministration of cholylsarcosine with ursodeoxycholic acid might provide additional benefit to primary biliary cirrhosis patients with an incomplete response to ursodeoxycholic acid. Our aim was to test the tolerability and the effect of adjuvant cholylsarcosine on liver tests and plasma cholesterol in primary biliary cirrhosis patients receiving ursodeoxycholic acid. Four primary biliary cirrhosis patients, who, despite more than a year of ursodeoxycholic acid therapy, had one or more liver tests persistently equal to or greater than twice the upper limit of normal, received cholylsarcosine (12-15 mg/kg/day) in addition to ursodeoxycholic acid (13-15 mg/kg/day) for six weeks in an open label study. Values of liver tests and plasma cholesterol, determined every two weeks, remained unchanged. One patient discontinued cholylsarcosine at week 4 because of new-onset pruritus. Analysis of duodenal bile acids in one patient showed 52% enrichment in cholylsarcosine and hydrophilic bile acids constituted 87% of total bile acids. It is concluded that the addition of cholylsarcosine to ursodeoxycholic acid did not influence liver tests in four primary biliary cirrhosis patients who had not responded completely to ursodeoxycholic acid alone. Cholylsarcosine was absorbed and became a dominant biliary bile acid; its administration was associated with increased pruritus.

Topical dissolution of cholesterol gallbladder stones using methyl tert-butyl ether (MTBE) is useful in symptomatic patients judged too ill for surgery. Previous studies showed that ethyl propionate (EP), a C5 ester, dissolves cholesterol gallstones rapidly in vitro, but differs from MTBE in being eliminated so rapidly by the liver that blood levels remain undetectable. Our aim was to test EP as a topical dissolution agent for cholesterol gallbladder stones. Five high-risk patients underwent topical dissolution of gallbladder stones by EP. In three patients, the solvent was instilled via a cholecystostomy tube placed previously to treat acute cholecystitis; in two patients, a percutaneous transhepatic catheter was placed in the gallbladder electively. Gallstone dissolution was assessed by chromatography, by gravimetry, and by catheter cholecystography. Total dissolution of gallstones was obtained in four patients after 6-10 hr of lavage; in the fifth patient, partial gallstone dissolution facilitated basketing of the stones. In two patients, cholesterol dissolution was measured and averaged 30 mg/min. Side effects were limited to one episode of transient hypotension and pain at the infusion site; no patient developed somnolence or nausea. Gallstone elimination was associated with relief of symptoms. EP is an acceptable alternative to MTBE for topical dissolution of cholesterol gallbladder stones in high-risk patients. The lower volatility and rapid hepatic extraction of EP suggest that it may be preferable to MTBE in this investigational procedure.

The adsorption of N2 molecules on Ni(110) has been investigated by high-resolution He-atom energy-loss spectroscopy. Two external vibrations in the subthermal (< 30 meV) energy regime at 5.75 and 4.5 meV have been observed and are shown to imply the existence of two different adsorption sites, which are assigned to an on-top and a bridge-site. This finding is at variance with the interpretation of data from electron energy loss spectroscopy and InfraRed (IR) spectroscopy, where only one mode of the internal stretch vibration v1 at frequencies is observed for the chemisorbed nitrogen molecules. A reanalysis of previously published high-resolution IR data reveals that the presence of the second unexpected adsorbate species correlates with a feature in the IR spectra, which previously has been assigned to N2 molecules adsorbed at defect sites. These findings reveal that in this case the external vibrations are significantly more sensitive to different adsorption sites than the internal vibration, the latter exhibiting a difference between on-top and bridge sites of less than 6 cm−1.

During the first two years of operation, the TCV tokamak has produced a large variety of plasma shapes and magnetic configurations, with 1.0 less than or equal to B-tor less than or equal to 1.46T, I-p less than or equal to 800kA, kappa less than or equal to 2.05, -0.7 less than or equal to delta less than or equal to 1. A new shape control algorithm, based on a finite element reconstruction of the plasma current in real time, has been implemented. Vertical growth rates up to 1000 s(-1) have been stabilized using the external coil system. Ohmic H-modes with Troyon factors (beta(tor)aB/I-p) up to two and densities up to 2.25 x 10(20) m(-3), corresponding to the Greenwald limit, have been obtained in diverted discharges. Limiter H-modes with Line averaged electron densities up to 1.7 x 10(20) m(-3) have been obtained in elongated D-shaped plasmas with 360 kA less than or equal to I-p less than or equal to 600 kA.

Ge0.2Si0.8 Quantum Well p-MOSFETs with very thin gate oxides of 5 nm, 2.5 nm cap-layer and an optional Boron doped delta layer fabricated in a standard 0.6 Μm CMOS process have been analysed by C-V and I-V measurements at different temperatures. The maximum low field hole mobility calculated from drain conductance was increased by 70%; from 67 cm2/Vs for a reference Silicon epi transistor to 115 cm2/Vs at 300 K and by 100%; from 110 cm2/Vs to 220 cm2/Vs at 98 K. These values were obtained at relatively high doping concentrations in the channel, the mobile channel charge was directly obtained from high and low frequency C-V curves. The influence of the net doping density in the channel region on the device characteristics is demonstrated. In the high electric field region the drain current in the saturation region was improved by 20%; for the same threshold voltage.

The development and growth pattern of solitary and multiple cholesterol gallbladder stones was defined using cholecystography in a prospective study of 48 patients whose initial cholecystograms indicated a stone-free gallbladder and who developed gallstones within the subsequent 5 years. Radiological observations performed over 365 patient-years were complemented by macroscopic examination, radiograms, scanning electron microscopy, and chemical analysis of gallstones from these and other patients obtained at cholecystectomy. Solitary gallstones were found to develop after a precursor phase of over 2 years during which free-floating crystal laminae of cholesterol formed. These laminae subsequently aggregated loosely and underwent external compaction and internal remodeling by movement of cholesterol molecules to form compact spheroids. A single lamina was observed to function as a nucleus for the development of a solitary stone shaped as an ellipsoid. About 10% of solitary stones were found to have a solitary pigment stone in their center. In contrast, multiple cholesterol gallstones formed without a precursor phase. Innumerable, very thin cholesterol crystals appeared which very abruptly aggregated to form spheres of up to 1 mm in diameter. Within 3 months a second aggregation took place in which these spheres colaesced to form mulberry stones. Mulberry stones in turn were transformed either to faceted stones (if many were present in the gallbladder) or to barrel stones (if few were present) over a period of 3 years. It is proposed that temporary occlusion of the cystic duct leads to supersaturation of bile with calcium bilirubinate and/or calcium carbonate which in turn promotes deposition of either or both of these calcium salts on the surface of single or multiple gallstones. For multiple gallstones, this process or the deposition of additional cholesterol crystals seals the gallstone surface and is followed by metamorphosis of the stone center.

Sepsis in the early stage is a common disease in emergency medicine, and rapid diagnosis is essential. The aim of our monocentric observational study (characterization of patients with sepsis in the emergency department) was to compare pathogen diagnosis by blood cultures (BC) and PCR.

The concentrations of taurine in a number of brain regions and in other tissues of rhesus monkeys fed a taurine-free human infant formula for 3 months are substantially lower than in similar monkeys fed the same formula supplemented with taurine. Activities of enzymes involved in taurine biosynthesis were not different in the two groups except for liver cysteinesulfinic acid decarboxylase, which was greater in the monkeys fed formula alone. There was no difference in the biliary bile acid composition, but the proportion of bile acids conjugated with taurine was significantly greater in the monkeys fed formula supplemented with taurine. These results indicate that the effects of a taurine-deficient diet on infant primates are widespread.

The time evolution of the electron density has been measured in the outer regions of a fast theta pinch by means of a Mach-Zehnder interferometer. The results show that the electron density outside the central plasma column is relatively high, i.e. between 1 and 5×1014 cm−3. A comparison of these measurements with theoretical calculations leads to the conclusion that the pinch must be unstable during the implosion phase.

Selected aspects of bile acid metabolism were assessed in six women with primary biliary cirrhosis and varying degrees of cholestasis. Urinary bile acid excretion was markedly increased and correlated highly with serum levels. In three patients in whom urinary bile acids were separated by chromatography, the majority of urinary bile acids were monosulfated (34%, 42%, 32%) or polysulfated and/or glucuronidated (30%, 20%, 38%). The monosulfates of chenodeoxycholic acid were conjugated at either the 3 position (67%, 68%, 73%) or the 7 position (33%, 32%, 27%); similarly, the monosulfates of cholic acid were conjugated at the 3 position (65%, 58%, 68%) or the 7 position (35%, 42%, 32%). The position of sulfation was not markedly influenced by the mode of amidation with glycine or taurine. Chenodeoxycholic exchangeable pool size, turnover rate, and synthesis were measured by isotope dilution and found to be well within normal limits, despite the cholestasis. The fraction of chenodeoxycholic acid synthesis excreted in urine ranged from 9 to 48%; 4--38% of chenodeoxycholic acid synthesis was sulfated. These data indicate that the major abnormalities in bile acid metabolism in patients with cholestasis secondary to primary biliary cirrhosis are formation of sulfated bile acids in greatly increased amounts, elevation of blood levels of primary bile acids, and a shift to renal excretion as a major mechanism for bile acid elimination. Chenodeoxycholic acid synthesis continues at its usual rate despite cholestasis. Whether these changes, including the formation of 7-monosulfated bile acids, occur in other forms of cholestasis and whether either the persistance of unchanged chenodeoxycholic acid synthesis or the formation of such novel conjugates has any pathophysiological significance remain to be investigated.

Effectiveness Dissolution of Gallstones. In almost every report of treatment of patients with cholesterol gallstones with UDCA, the calculation of the success rate is based on the sum of the complete and partial dissolutions, in this review~ only complete disappearance of the gallstones is accepted as a successful result, since reduction of size during treatment does not guarantee that continued treatment will result in complete dissolution. Data from publications which do not distinguish between partial and complete dissolution in presenting the rate of successful treatment are therefore not included in the tabulations. Furthermore, some of the authors display their data in a way which makes it impossible to understand their results. This is attributable in no small measure to changes of dosage during the trial instead of continuing with a given dose in a given patient. Where the dose is stated in mg/kg/day, it was certainly not prescribed that way. The investigators prescribed the number of tablets or capsules to be taken daily, then calculated the dose on a weight basis. The smallest number of patients in any series was 12 (140), the largest 106 (145), the latter a multicenter study. The total number of patients entered in all series (Table 18) was 852, of whom 128 (15%) dropped out. Drop-outs are defined in this review as

Validation of Use of 11, 12- 2 H-Labeled Chenodeoxycholic Acid in Isotope Dilution Measurements of Bile Acid Kinetics in Man

A dose-response study comparing ursodeoxycholic and chenodeoxycholic acid was carried out in six men with asymptomatic radiolucent gallstones present in well-visualizing gallbladders. The study tested the effects of a low (averaging 6 mg/kg/day) or medium dose (averaging 11 mg/kg/day) of each bile acid on the cholesterol saturation of bile as well as on bile acid metabolism, as inferred from biliary and fecal bile acid composition. Ursodeoxycholic acid, at low or medium doses, induced bile desaturation in most patients, whereas chenodeoxycholic acid did not. Despite the greater desaturation efficacy of ursodeoxycholic acid, biliary bile acids became less enriched with the administered bile acid during ursodeoxycholic acid treatment than during chenodeoxycholic acid treatment. Both bile acids were nearly completely 7-dehydroxylated to lithocholic acid by colonic bacteria, but biliary lithocholic increased only slightly (and similarly) with each bile acid. Fecal bile acid composition suggested that administered ursodeoxycholic acid suppressed endogenous bile acid synthesis much less than chenodeoxycholic acid. The results indicate that ursodeoxycholic acid and chenodeoxycholic acid have similar but not identical effects on bile acid metabolism, but that for a given dose, ursodeoxycholic acid is a more potent desaturating agent than chenodeoxycholic acid. The results suggest that cholesterol gallstone dissolution with ursodeoxycholic acid should occur with a dose of 8-10 mg/kg in most nonobese patients.

Electron temperature and density were measured in the rotating magnetic field pinch by means of laser light scattering. The results are compared with previous measurements and with numerical calculations based on a three-fluid magnetohydrodynamic model. The comparison between theory and experiment shows that the interior surface of the discharge tube acts as a plasma source producing approximately 0.6*1015 electron-ion pairs per cm2 per μs.

Bile acids are capable of disrupting the gastric and esophageal mucosal barriers and are known to differ in their ability to injure these mucosae. Two bile acids, chenodeoxycholic and its 7-B epimer, ursodeoxycholic, that are being used to dissolve gallbladder stones were evaluated for their damaging effects on experimental preparations of the esophageal (rabbit) and gastric (dog) mucosa. Damage was assessed by measuring indices of mucosal barrier function, including net acid flux, potential difference, and tissue resistance, before and after exposure to the taurine conjugates of these bile acids. In both the esophageal and gastric mucosa, tauroursodeoxycholic acid caused significantly less disruption of barrier function than taurochenodeoxycholic acid. These results demonstrate that minor differences in conjugated bile acid structure can cause major changes in the effects of bile acids on the upper gastrointestinal mucosa and that ursodeoxycholic acid may be the preferred bile acid for oral ingestion to dissolve gallbladder stones.

In this article we pick up a problem stated in [1], namely the question whether PNlog-nets allow to solve synchronization problems not solvable by ordinary Petri nets under certain simulation rules. We show that a slight and reasonable strengthening of the simulation rules defined in [1] enables us to answer the raised question in the positive. As will be pointed out in the introduction, with this result we “partially” solve the original problem.

Unter Anwendung einer neuen Methode wurde die Wirkung von 7-[2-Hydroxy-3-(N-2-hydroxy-athyl-N-methylamino)propyl]-1,3-dimethylxanthin,-pyridin-3-carboxylat (Complamin) [NST] auf das experimentelle traumatische Hirnodem untersucht. Dabei wurde bei Ratten nach einer Commotio cerebri die Zunahme des Wasser-, Natrium- und Kaliumgehaltes im Hirngewebe verfolgt und der Einflus des NST konnte nun direkt an Hand der Ausschwemmung des Odemwassers gepruft werden. NST wurde zu verschiedenen Zeitpunkten nach dem Schadeltrauma verabreicht. Bei allen gepruften Kollektiven fand sich eine deutliche, z.T. fast vollstandige Verminderung der Odemflussigkeit und des Natriums. Auffallend war eine eindeutige Abnahme der Wirkung des NST mit zunehmendem Abstand von der Commotio.