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Our professional and personal lives have been changed, temporarily and perhaps permanently, due to COVID-19. Estate planners have engaged in considerable discussion of the estate planning interface between the coronavirus stay-at-home orders and the imposition of social distancing. This article summarizes how you may wish proceed in light of these challenging circumstances to represent your estate planning clients and have their documents validly executed.

Less than a few decades ago, technology had a minor impact on the legal profession. Today, a wide range of technology may be central to a lawyer’s practice, changing the way we plan for the future. While the integration of technology in the legal world has had its many benefits, keeping up with the wide array of rapidly changing technology now available is a dubious task for many practicing lawyers. To stay ahead of the curve in your estate planning practice and lessen potential frustration and expense, it is important to understand and leverage the latest estate planning technology. This article will serve to inform estates and trusts lawyers of the available technology tools along with their benefits and disadvantages, with a special discussion of cryptocurrency and electronic wills.

Highly crystalline microcrystalline silicon carbide (μc-SiC:H) with excellent optoelectronic material properties is a promising candidate as highly transparent doped layer in silicon heterojunction (SHJ) solar cells. These high quality materials are usually produced using hot wire chemical vapor deposition under aggressive growth conditions giving rise to the removal of the underlying passivation layer and thus the deterioration of the crystalline silicon (c-Si) surface passivation. In this work, we introduced the n-type μc-SiC:H/n-type μc-SiO x :H/intrinsic a-SiO x :H stack as a front layer configuration for p-type SHJ solar cells with the μc-SiO x :H layer acting as an etch-resistant layer against the reactive deposition conditions during the μc-SiC:H growth. We observed that the unfavorable expansion of micro-voids at the c-Si interface due to the in-diffusion of hydrogen atoms through the layer stack might be responsible for the deterioration of surface passivation. Excellent lifetime values were achieved under deposition conditions which are needed to grow high quality μc-SiC:H layers for SHJ solar cells.

Die Verminderung der entzundlichen Krankheitsaktivitat allein ist aus Sicht von Menschen mit rheumatischen Krankheiten kein ausreichendes Behandlungsziel. Vielmehr mussen die funktionale Gesundheit und Teilhabe verbessert werden. Dabei sind auch die betroffenen Patienten von Beginn an zum eigenverantwortlichen Krankheitsmanagement zu befahigen. Deshalb ist die etablierte Treat-to-Target-Strategie um die funktionelle Dimension im Sinne von „Treat to Participation“ zu erweitern. Das Positionspapier der Deutschen Gesellschaft fur Rheumatologie (DGRh) fasst relevante Handlungsfelder der vielfach dazu erforderlichen multimodalen Versorgung zusammen. Dazu gehoren der Erwerb funktionsorientierter Kompetenzen in der Aus-, Weiter- und Fortbildung und deren regelhafte Anwendung in der rheumatologischen Versorgungspraxis. Weiterhin sieht die DGRh Bedarf in der Forschung zu funktionellen und sozialmedizinischen Folgen rheumatischer Krankheiten sowie zu funktionsorientierten Einzelinterventionen und deren Kombination in komplexen Programmen der ambulanten und stationaren rheumatologischen Versorgung.

Malignant gliomas are a devastating brain tumor disease with very poor prognosis. Stereotactic biopsy sampling is routinely used in larger neurosurgical centers to confirm the diagnosis of a suspected brain tumor. This procedure is associated with risk of blood vessel rupture as well as false-negative results. Recent investigations suggest a potential of light-based techniques to improve both therapy and diagnosis of GBM. Optical guidance can be utilized to improve the biopsy sampling procedure in terms of safety, reliability, and efficacy. Recording of optical signals (transmission, remission, fluorescence) can be potentially integrated into a biopsy needle for providing optical detection of tumor tissue and blood vessel recognition during the biopsy sampling. Optical signals can also be used for monitoring purposes during photodynamic therapy. Here, fluorescence signals recorded before the treatment indicate the presence and accumulation level of photosensitizer, while photobleaching of the photosensitizer fluorescence during the treatment can be used as a measure of the effectiveness of the therapy. Finally, transmitted light can reveal problematic tissue-optical conditions as well as changes of the optical properties of the treated tissue, which may be relevant with regard to treatment prognosis and strategy. Different optical concepts for interstitial PDT monitoring and optical tissue property assessment are presented.

In aktuellen Leitlinien der Deutschen Gesellschaft fur Rheumatologie (DGRh) wird eine koordinierte multiprofessionelle Behandlung und Rehabilitation von Patienten mit entzundlich-rheumatischen Krankheiten gefordert. In der Realitat sind Rehabilitationsleistungen der Deutschen Rentenversicherung (DRV) bei diesen Patienten von 2000 bis 2012 bundesweit zuruckgegangen, am deutlichsten bei Mannern mit ankylosierender Spondylitis (AS) um fast ein Drittel. Daruber hinaus zeigen sich fur stationare Rehabilitationsleistungen der DRV wegen rheumatoider Arthritis (RA) zwischen den Bundeslandern Unterschiede um den Faktor 2,6. Rehabilitationsleistungen wegen RA oder AS werden von der DRV bis zu 14-mal haufiger durchgefuhrt als von einer der grosten Krankenkassen, die gesetzlich fur die Rehabilitation jenseits des Erwerbslebens zustandig sind. Die Struktur- und Prozessqualitat sind in Rehabilitationseinrichtungen mit hohen Zahlen von Patienten mit entzundlich-rheumatischen Krankheiten deutlich erhoht. Unter den RA-Patienten in deutschen Rheumazentren sind im Jahr 2011 noch 40 % von mittelgradigen bis erheblichen Alltagseinschrankungen (Funktionsfragebogen Hannover [FFBH] ≤ 70) betroffen. Dennoch halbierten sich nach den Daten der Kerndokumentation von 1995 bis 2011 die stationaren Rehabilitationsleistungen fur RA-Patienten mit FFBH ≤ 70 um etwa die Halfte. In ambulanter rheumatologischer Versorgung erhielten nach eigenen Angaben innerhalb der letzten 12 Monate 38 % der RA-Kranken mit FFBH

Prudent professionals must address digital assets in all estates they plan or administer. The 2017 Texas Legislature enacted the Texas Revised Uniform Fiduciary Access to Digital Assets Act as Chapter 2001 of the Estates Code which adds clarity to the steps you need to take when planning and administering estates. This article aims to provide the information you need to be well-informed about the cyberspace-estate planning interface.

Epstein-Barr virus (EBV), a member of the herpesvirus family, is one of the most common human viruses affecting more than 90% of the world's population. The most common manifestation of primary infection is a self-limited clinical syndrome that most frequently affects adolescents and young adults. The incidence of clinical infectious mononucleosis is not well documented because reporting is not obligatory in most states. The available data have been derived from special surveys such as the community survey in Olmstead County, Minnesota, which includes the Mayo Clinic, where a rate of 200 per 100,000 patients had a positive heterophile test.1 Once a diagnosis of mononucleosis is confirmed, treatment is supportive because there is no specific treatment for the disease. Mononucleosis is rarely fatal but some complications include central nervous system involvement, splenic rupture, upper airway obstruction, and bacterial super infections. The following clinical case is of a patient diagnosed with acute infectious mononucleosis with Staphylococcus aureus pharyngitis co-infection.

Perhaps the most difficult thought to ponder is one’s own mortality. Many people avoid confronting the grim reality that they and their loved ones will eventually die. Estate planners must sensitively urge their clients to face the inevitability of death to obtain well-reasoned dispositions of their property. Many clients are also very concerned with the final disposition of their bodies. For example, some individuals want to be buried while others prefer to be cremated.An estate planner needs to take steps to help insure that a client’s body will be handled after death in accordance with the client’s wishes. The estate planner must also work to reduce the chances of those wishes being frustrated either by lack of information to the individuals making disposition arrangements or by individuals surviving the client who are unhappy with the deceased’s disposition requests.Unfortunately, many estate planners ignore or deal superficially with their clients’ body disposition concerns. Accordingly, this article details the techniques which Texas estate planners may use to assist their clients to receive the body disposition they desire.

The 2015 Texas Legislature enacted a “Texasized” version of the Uniform Real Property Transfer on Death Act joining over a dozen other states that have already done so. Transfer on death deeds (hereinafter “TODDs”) were previously authorized under Estates Code § 111.052 (recodifying Probate Code § 450) which validates “any provision in a...conveyance of property...stating that...property that is the subject of the instrument shall pass, to a person designated by the decedent in the instrument.” However, this “bare-bones” provision provided little guidance with regard to the myriad of issues that these type of deeds could raise. Passage of this legislation was designed to bring greater clarity to this technique. This article discusses the operation of the new statute.

Der Aufgabenbereich des TC 57 umfasst nicht einzelne Komponenten wie etwa Schalter, Trenner, Schutzfunktionen etc., sondern ein vernetztes System von der Uberwachung und Steuerung der Primartechnik in Unterstationen bis in die ubergeordnete Netzleitstelle mit internem Informationsaustausch sowie Schnittstellen zu externen Systemen.

The commission "Rehabilitation" of the German Society of Rheumatology compiled a data set for a routine report of the rehabilitation system for muskuloskeletal diseases. More than 250 rehabilitation hospitals offer inpatient rehabilitation for patients with musculoskeletal diseases. The prevalence of inpatient rehabilitation decreased due to new legislative rules in 1997, increased again thereafter but has not reached the former level. The prevalence of inpatient rehabilitation during the preceding year in patients with inflammatory rheumatic diseases treated by rheumatologists amounts to 12% with higher figures in men than in women and lower figures in the area of the former German Democratic Republic. The prevalence of outpatient rehabilitation increased during the last few years but, currently, does not exceed 5% of the entire rehabilitation procedures.

BACKGROUND Modern patient based outcome measures like the SMFA-D (German Short Musculoskeletal Function Assessment Questionnaire) are able to detect the impairment and functional capacity of patients with musculoskeletal extremity disorders. The SMFA-D was successfully evaluated in several cohorts treated operatively for osteoarthritis of the knee and hip, rotator cuff tears and rheumatoid arthritis. The aim of the present study was the evaluation of the SMFA-D in patients with conservative treatment for hip osteoarthritis. PATIENTS AND METHODS 69 patients with osteoarthritis of the hip were enrolled in a prospective controlled clinical trial. All patients completed the SMFA-D, SF-36, WOMAC, FFbH-OA. A standardized test of walking speed and the functional status of the patient as judged by the physician were recorded. Statistical analysis were done for the following: re-test reliability (ICC), internal consistency (Cronbach's alpha), validity and responsiveness. RESULTS Internal consistency (Cronbach's alpha) was alpha = 0.89 and alpha = 0.97 for the SMFA-D scales. The retest reliability (ICC, unjust, mixed effect) was 0.91 (p < 0.001) for the function index and 0.73 (p < 0.001) for the bother index. Both indices correlated significantly with the FFbH-OA (r = 0.66 to r = 0.84), the WOMAC (r = 0.55 to r = 0.86) and the scales of the SF-36 (r = - 0.34 to r = - 0.85) on all three time points, which supports construct validity. There was mainly a significant correlation between the SMFA-D scales and the functional status of the patient (r = 0.21 to r = 0.44), pain reported by the patient (r = 0.43 to = 0.54) and the self selected walking speed (r = 0.28 to r = 0.51), which supports external validity. We were able to differentiate operatively and conservatively treated patients (discriminant construct validity). At the end of the rehabilitation program we were able to demonstrate small to medium treatment effects in SMFA-D and SF-36. The WOMAC and FFbH-OA were not able to demonstrate these treatment effects. CONCLUSION Even in patients with conservative treatment of hip osteoarthritis the SMFA-D represents a reliable, valid and responsive measure. The use of the SMFA-D can be recommended as a patient based outcome measure.

This document contains the Texas Estates Code showing all changes made by the 2015 Texas Legislature. The changes, most of which take effect on September 1, 2015, are shown in red-lined format for easy comparison of the prior and new versions of the statutes. I have included commentary entitled Statutes in Context to many sections. These annotations provide background information, explanations, and citations to key cases which should assist you in identifying the significance of the statutes and how they operate.

By application of a standardized core set of outcome measurement instruments, comparison between studies as well as meta-analyses in rehabilitation research can be facilitated. The German Society for Rheumatology has commissioned its working group on rehabilitation with the development of a proposal for such a core set of outcome measurement instruments. In a first step, dimensions for outcome measurement in rehabilitation were defined by a group of experts which represented rehabilitation hospitals, acute care hospitals, and research groups specialized in outcome measurement. The Delphi method was used in a multiple step consensus process. In a second step, instruments and procedures to operationalize the relevant dimensions were chosen. Reliability, validity, sensitivity to change, and practicability were used as criteria for selecting measurement instruments. The main intention of the proposed core set of outcome measurement instruments is to facilitate the processes of planning and carrying out rehabilitation research studies. Furthermore, the proposed instruments can be used for clinical documentation systems as well as for internal or external quality assurance programs.

Point-of-care whole blood coagulation tests are critical in the management of patients who undergo percutaneous coronary intervention. The Hemochron and HemoTec devices have been traditionally used to measure the activated clotting time (ACT) in the cardiac catheterization laboratory. The heparin management test (HMT) was recently introduced into clinical practice as an alternative method to current ACT measurements that uses a different sample volume, contact activators and detection system to measure whole blood coagulation. We compared the HMT to the HemoTec ACT in 68 prospectively enrolled patients (127 blood samples) undergoing percutaneous coronary intervention. Measurements were performed 10 minutes after the initial heparin bolus and thereafter at the discretion of the attending physician. The mean HMT was 41 seconds higher (∼15%) than the HemoTec ACT (HMT 304±59 vs. ACT 263±52, P< 0.0001), but there was a significant correlation between the methods (r=0.77, P

Zusammenfassung Ziel: Anhand einer retrospektiven Untersuchung wurde überprüft, inwieweit der routinemäßige Einsatz des Röntgenthorax auch bei Low-risk-Patienten trotz der hohen Sensitivität des Tumormarkers Thyreoglobulin sinnvoll ist. Methode: Es wurden die Krankengeschichten von 609 Patienten mit einem differenzierten Schilddrüsenkarzinom ausgewertet. Bei 50 Patienten wurde eine pulmonale Metastasierung diagnostiziert. Der Thyreoglobulinwert zum Zeitpunkt der Diagnosestellung der pulmonalen Metastasierung wurde mit dem Befund des Röntgenthorax und der vorhandenen weiteren Diagnostik, wie der lod-131-Ganzkörperszintigraphie und CT des Thorax, soweit vorhanden, verglichen. Ergebnisse: Die gefundene Sensitivität des Röntgenthorax im Nachweis von Lungenmetastasen lag mit 52% unterhalb der Sensitivität der 131 -lod-Ganzkörperszintigraphie (64%), der Thorax-CT (82%) und der Sensitivität des Thyreoglobulins unter Suppressionsbedingungen (86%). Bei Patienten mit papillärem Schilddrüsenkarzinom der Tumorstadien I und II entwickelte nur ein Patient im Verlauf eine Lungenmetastasierung. Der Nachweis von Lungenfiliae nur mit Hilfe des Röntgenthorax bei einem Thyreoglobulinwert unter der Nachweisgrenze ist in einer solchen Low-risk-Gruppe sehr selten (berechnete Wahrscheinlichkeit: 1:4000) und mit erheblichen Kosten verbunden. Schlußfolgerung: Der routinemäßige, lebenslange Einsatz des Röntgenthorax ohne Rezidivverdacht (z. B. Thyreoglobulin positiv) ist für Low-risk-Patienten zu überdenken.

Summary Background PET using 18fluorodesoxyglucose (FDG) may offer the possibility of differentiating vital from necrotic residual masses. Patients and methods Seventeen patients with HD and 17 patients with NHL underwent FDG-PET following therapy. According to staging by routine methods at diagnosis, 7 patients presented stage I, 13 stage II, 5 stage III, and 9 stage IV. A dose of 250–400 MBq FDG was injected and whole-body PET was performed 30–60 minutes later. Results Residual mass was found in 32 patients with routine methods. FDG-PET was negative in 17 patients, who were considered to be in CR. None of them relapsed (median follow-up 63 weeks). FDG-PET was positive in 17 patients. Sixteen patients had residual mass with routine methods. Four patients received radiation after PET. Their median follow-up is 58 weeks without relapse. Two other patients with lasting CR had FDG uptake outside the residual mass - one with confirmed pneurnonia. Five patients had histologically confirmed lymphoma, 2 patients relapsed according to routine methods. One patient is likely to be false positive because of fracture at lymphoma site. Seven of 10 patients with FDG uptake in the residual mass after completed therapy relapsed. According to routine restaging, 2 patients achieved CR. In 1 patient an additional focus was found in the humerus in spite of normal scintigraphy with histologically confirmed lymphoma. There were no false-negative results, but 3 false-positive results inside and 2 false-positive results outside the residual mass after completed therapy. Conclusions PET performed for evaluation of residual mass after treatment of lymphoma has a high predictive value.

Dogs, cats, parrots, and other pet animals play extremely significant roles in the lives of many individuals. People own pets for a variety of reasons – they love animals, they enjoy engaging in physical activity with the animal such as playing ball or going for walks, and they enjoy the giving and receiving of attention and unconditional love. Research indicates that pet ownership positively impacts the owner’s life by lowering blood pressure, reducing stress and depression, lowering the risk of heart disease, shortening the recovery time after a hospitalization, and improving concentration and mental attitude.The primary goal of the pet owner’s attorney is to carry out the pet owner’s intent to the fullest extent allowed under applicable law. Accordingly, the attorney should select a method which has the highest likelihood of working successfully to provide for the pet after its owner’s death. (The pet owner should also determine if any special arrangements need to be made to care for the pet if the owner becomes disabled.) After discussing the history of providing for a pet after the owner’s death, this article discusses the variety of techniques currently available and comments on the advisability of each.Special features of this article include: sample pet trust provisions; "client-friendly" FAQs; summary of tax concerns with pet trusts; comprehensive appendix with links to all pet trust statutes (46 states plus D.C.).

Based on follow-up examinations of 16 patients aged 5 to 15 years, the integrity of the interosseous membrane following forearm shaft fracture was evaluated. The examinations which included magnetic resonance imaging (MRI) and ultrasound scanning of both the fractured and the nonfractured forearms were conducted 4 to 81 months after fracture. Using a 1.5 T MR tomograph, we obtained 20 cross-sectional images arranged over the entire length of the forearm which was in neutral position, while sonographicly at 7.5 MHz we obtained cross-sectional views of the proximal, middle and distal forearm thirds with the forearm in pronation, neutral position and supination at a time. The MR image of the interosseous membrane is a thin hypointense line, occasionally showing low contrast irregularities on the fractured side such as thickenings, tears or curvature inconstancies which would suggest membrane alterations. However, these alterations appear to be less than expected. They are not clearly seen in the ultrasound views, where the interosseous membrane is found as an echorich line. According to our preliminary results, there seems to be a correlation between MR-detected interosseous membrane alterations and initial fracture dislocation as well as functional fracture outcome, particularly forearm rotation.

Fragestellung: Dysplasien ulva und Portio uteri sind haufig multizentrisch, rezidivierend und mussen meist operativ entfernt werden. Wir untersuchten, ob die photodynamische Laserthe

Recently, a new subdivision of property has emerged that many people label as “digital assets” such as accounts used for e-mail, professional and personal data backups, banking, investment, and shopping, domain names and web-hosting accounts, social networking accounts, and avatars for online games. While estate planners have perfected techniques to transfer traditional types of property, many estate planners do not address digital assets when preparing their clients’ estates.This article aims to educate estate planning professionals on the importance of planning for the disposition of digital assets, provides those planning techniques, and discusses how to administer an estate containing digital assets. The appendix contains a sample form which may be used to organize digital assets.

This article discusses recent judicial developments relating to the Texas law of intestacy, wills, estate administration, trusts, and other estate planning matters. The discussion of each case concludes with a moral, i.e., the important lesson to be learned from the case. By recognizing situations that have led to time consuming and costly litigation in the past, estate planners can reduce the likelihood of the same situations arising with their clients.

Estate Administration Seminar in San Antonio, TX, An estate planner must always be on guard when drafting instruments which may supply incentive for someone to contest a will. Anytime an individual would take more through intestacy or under a prior will, the potential for a will contest exists, especially if the estate is large. Although will contests are relatively rare, the prudent attorney must recognize situations which are likely to inspire a will contest and take steps during the drafting stage to reduce the probability of a will contest action and the chances of its success. This article begins by discussing the situations where a will contest is more likely and then discusses a wide range of techniques which may be helpful in preventing will contests.

An estate planner may become a defendant in a case involving an estate he or she planned in two main ways. First, the attorney may have performed his or her services in a negligent manner potentially creating exposure to malpractice liability. Second, the attorney’s conduct may have lapsed below ethically acceptable standards.This article reviews the exposure an estate planner may have to malpractice liability with emphasis on Texas law and then focuses the reader’s attention on ethical issues that may arise while preparing or executing the plan. I hope that by pointing out potentially troublesome areas, the reader will avoid the ramifications of drafting a flawed estate plan or having a lapse of ethical good judgment which may lead to the frustration of the client’s intent, financial loss to the client or the beneficiaries, personal embarrassment, and possible disciplinary action.

Photodynamic therapy (PDT) of tumours in hollow organs requires light application devices which enable homogeneous illumination of the tissue surface in hollow organs. This paper presents two laser light application systems generating a homogeneous light distribution and one monitoring unit which detects variations in the applied laser light intensity during treatment.

Esmarch was born on 9 January 1823 in northern Germany, into a family of physicians, judges and lawyers with a long academic tradition. His father was a highly respected surgeon, who encouraged his gifted son to follow in his footsteps. von Esmarch began his medical studies at the University of Kiel in 1843, to graduate only 3 years later from the University of Gottingen. His career advanced at a rapid pace and he received an appointment as professor and chairman of the department of surgery at the University of Kiel. In 1867 von Esmarch married, an aunt of Emperor Wilhelm II, who raised him to the rank of a peer in 1887 in recognition of his outstanding achievements in the field of medicine. von Esmarch founded the German Society of Surgeons and was named president in 1894. On 23 October 1908 he died from the effects of an influenza infection. In the early 19th century the focus of surgical interventions was primarily on the body surface and the extremities. From the beginning of his medical career von Esmarch showed a passionate interest in trauma care, placing the emphasis on reconstructive surgery instead of the conventional practice of limb amputation in battle victims. The political climate of the time favoured decisions made on the battlefield over diplomatic solutions and his work as a surgeon in the campaigns against Denmark, led by Bismarck in 1848 and 1864, provided him with ample experience in the treatment of war injuries. In contrast to the rapid progress in war technologies with all their horrible consequences, improvements in the military medical service sadly lagged behind and the soldiers received inadequate treatment under unacceptable conditions which had remained unchanged over the preceding centuries. Common consequences of surgical interventions were wound infections, frequently leading to the death of a patient due to massive septic shock. In the 1850s the causes of wound infections were still largely unknown by the practising physicians. von Esmarch’s observation that the cooling of wounds resulted in a reduction in local inflammation and pus-formation and thus to an improvement in the patient’s outcome led him to introduce cryotherapy into clinical practice. In 1862 he published his findings, introducing his new therapeutic

Multiple-party accounts, such as checking accounts, savings accounts, and certificates of deposit, are contractual arrangements for the deposit of money with financial institutions such as state or national banks, savings and loan associations, and credit unions. The disposition of the funds remaining in these accounts upon the death of one of the depositors depends on the type of account, the account contract, and the applicable state law.Multiple-party accounts are important non-probate transfer mechanisms because these accounts are used widely, easy to understand, and inexpensive to obtain. This article discusses the four commonly recognized types of multiple-party accounts: (1) the joint account, which may transfer ownership rights to the account’s balance to the surviving party; (2) the agency or convenience account, which does not transfer the account’s balance upon the death of one of the parties; (3) the payable on death account, which causes the balance to belong to the surviving pay on death payees upon the death of the depositors; and (4) the trust account, under which the beneficiaries receive the account’s balance upon outliving all trustees.

Most pet owners are extremely devoted to their pets, often considering them members of the family. This devotion can carry over into the owner’s will or trust, leaving gifts for their pets in such instruments. A will or trust involving the pet can be important to the veterinarian because, for example, a trust could specify whether and under what circumstances a medical procedure or euthanasia may take place. This article provides an overview of pet trusts, including historical background and current developments, pet trust basics, and a discussion of key concerns for veterinarians relating to pet trusts.

OBJECTIVES This study was conducted to test the hypothesis that plasma markers of oxidized low-density lipoprotein (OxLDL) reflect acute coronary syndromes (ACS). BACKGROUND Oxidized LDL contributes to the pathogenesis of atherosclerosis, but its role in ACS is not established. METHODS Serial plasma samples were prospectively obtained from patients with an acute myocardial infarction (MI) (n = 8), unstable angina (UA) (n = 15), stable coronary artery disease (CAD) (n = 17), angiographically normal coronary arteries (n = 8), and from healthy subjects (n = 18), at entry into the study, hospital discharge (MI group only), and at 30, 120, and 210 days. Chemiluminescent enzyme-linked immunosorbent assay was used to quantitate plasma levels of: 1) immunoglobulin (Ig)M and IgG OxLDL autoantibody titers (presented as a mean OxLDL autoantibody titer by averaging the results of four distinct epitopes); 2) LDL-autoantibody immune complexes (LDL-IC); and 3) minimally OxLDL measured by antibody E06 (OxLDL-E06), as determined by the content of oxidized phospholipids (OxPL) per apolipoprotein B-100. RESULTS Baseline OxLDL IgG autoantibody levels were higher in the MI group (p < 0.0001). At 30-day follow-up, the mean IgM OxLDL titers increased by 48% (p < 0.001) and 20% (p < 0.001), and IgM LDL-IC increased by 60% (p < 0.01) and 26% (p < 0.01) in the MI and UA groups, respectively. The OxLDL-E06 levels increased by 54% (p < 0.01) in the MI group at hospital discharge and by 36% at 30 days. No significant changes in any OxLDL markers were noted in the other groups. The OxLDL-E06 levels strongly paralleled the acute rise in lipoprotein(a), or Lp(a), in the MI group, suggesting that toxic OxPL are preferentially bound to Lp(a). Oxidized LDL-E06 also correlated extremely well with Lp(a) in the entire cohort of patients (r = 0.91, p < 0.0001). CONCLUSIONS Circulating OxLDL-specific markers strongly reflect the presence of ACS, implying immune awareness to newly exposed oxidation-specific epitopes and possible release of OxLDL in the circulation. The OxLDL-E06 measurements provide novel insights into plaque rupture and the potential atherogenicity of Lp(a).

A 'thermophoretic pellicle' has been proposed as an alternative to the traditional organic pellicle as a means of protecting EUV lithographic photomasks from particle contamination. The thermophoretic pellicle protects a mask from particles by exploiting the thermophoretic force, which is exerted on a particle by a surrounding gas in which a temperature gradient exists. Two critical requirements of the thermophoretic pellicle are: 1) the mask is kept warmer than its surroundings (either by heating the mask or by cooling the surroundings) and 2) the surrounding gas pressure is kept sufficiently high to enable thermophoretic protection. Experiments are presented which verify the viabilitiy of thermophoretic protection for EUV masks under model conditions. In these experiments, wafers are exposed to monodisperse polystyrene latex (PSL) spheres under carefully controlled experimental conditions. Robust thermophoretic protection is observed over a wide range of argon gas pressures (50-1600 mTorr or 6.66-213 Pa), particle sizes (65-300 nm), and temperature gradients (2-15 K/cm).

Fluorine-18 fluorodeoxyglucose and positron emission tomography (FDG-PET) is a new imaging modality used in the follow-up of patients with differentiated thyroid cancer if the results of (131)I scintigraphy are negative in spite of an elevated thyroglobulin level. The aim of this retrospective analysis was to estimate the value of FDG-PET regarding the operability of patients with positive findings. From January 1994 to October 1997, we investigated 60 patients with differentiated thyroid carcinoma by FDG-PET. Thirteen patients were operated on after positive findings. Most of these lesions were suspected of having lymph-node involvement or local recurrences in the thyroid bed. One patient showed a solitary distant metastasis in the scapula. Thirteen of 16 operations in these 13 patients confirmed the suspected involvement of thyroid cancer. The false-positive findings were caused by inflamed lymph nodes in two cases and benign thymus tissue in one case. We conclude that PET is a useful diagnostic tool to guide early surgical therapy in patients with (131)I negative differentiated thyroid carcinoma.

One of the current challenges in diagnostic radiology is the early and accurate detection of pancreatic carcinoma and its differentiation from mass-forming pancreatitis using noninvasive imaging methods [1, 2]. The diagnostic accuracy of morphologically oriented imaging techniques is presently suboptimal. Ultrasonography is hampered by the dorsal position of the pancreas in the abdomen and the location of the bowel in front of it. Computed tomography (CT) and magnetic resonance imaging (MRI) have excellent geometric resolution, but the differentiation between malignant and benign lesions remains difficult even with these leading technologies. Conversely, functionally oriented nuclear medicine procedures enable imaging of organ metabolism using appropriate radio-labelled tracers. At the beginning, the aim of radioisotope studies was merely the visualization of pancreatic tissue. To this purpose selenium-75-selen methionine and 123I-N,N,N′-trimethyl-N′-(2-hydroxy-3-methyl-5-iodobenzyl)-1, 3-propanediamine ([123I] HIPDM) were tested. Both tracers accumulate in normal pancreatic tissue, but they cannot differentiate between malignant tumors and benign lesions [3, 4]. Thus, in the era of high resolution radiological methods, they are of a more historical interest. Recently, the introduction of several new types of tracers opened exciting perspectives. In this chapter the possibilities of these radiopharmaceuticals will be discussed.

Successful photodynamic therapy requires homogeneous irradiation and light detection for dosimetry. Light delivery devices and detectors for treatment of spherical and cylindrical hollow organs have been developed. For photodynamic therapy of multifocal superficial bladder tumours a catheter with an isotropic emitter is centred by a balloon. Light which is backscattered from the tissue surface is used for on-line dosimetry. The irradiation and dosimetry concept has been proven by computer simulations for a non-spherical bladder shape. Larynx, bronchi, oesophagus and cervix have been irradiated by devices adapted to the shape of the organ. The light distribution is homogenized by multiple backscattering from a nearly white layer in contact with tissue, a promising method also for hollow organs with irregular geometry. The homogeneity of the light distribution as well as the dosimetry have been improved by the devices to be presented.

Study Design This study analyzed anatomic characteristics of the alar ligaments and the possibility of imaging them with magnetic resonance imaging. Also determined was whether artificial ruptures of the alar ligament can be recognized experimentally. Objective To determine the ability of magnetic resonance imaging to visualize normal, torn, and resected alar ligaments. Summary of Background Data There are no studies about computed tomography or magnetic resonance imaging findings of alar ligaments and after anatomic sections. Direct visualization of the complete ligement if not possible by computed tomography. No precise diagnostic method for showing a ruptured alar ligaments has been described. Magnetic resonance imaging seems to be the method of choice for distinguishing between normal and pathologic soft tissue. Methods Fifteen spacimans from accident victims underwent anatomic dissection. In addition, ligaments from three groups were examined: 1) eight volunteers, 2) seven patients, and 3) 17 fresh cadaveric specimen before anatomic exploratory dissection. In seven of these specimens, one ligament was cut to simulated an artificial disruption and magnetic resonance imaging was repeated. Results Lesions of the alar ligaments were found in four of 15 prepared specimens. Using magnetic resonance imaging, the alar ligaments could be identified in all volunteers, patients, and specimen except one. No ruptures were found in the 17 specimens. Of the seven resected specimens, all cuts could be demonstrated by magnetic resonance imaging. Conclusion Magnetic resonance imaging is useful for showing lesions of the alar ligaments because of a high soft tissue contrast plane independence imaging, posibility of functional scans, and secondary reconstruction from three-dimensional data sets.

Bei der Anwendung der photodynamischen Lasertherapie (PDT) werden Photosensibilisierende Substanzen wie Phorofrin II oder Photosan III intravenos verabreicht. Dabei treten Nebenwirkungen wie eine erhohte Lichtempfindlichkeit der Haut auf. In der Gynakologie konnte dies bei der Behandlung oberflachlicher Neoplasien und Prakanzerosen der Portio uteri durch topische Applikation des Photosensibilisators auf das befallene Organ vermieden werden. Fur die lokale Anwendung des Photosensibilisators ist es notwendig, das Penetrationsverhalten, die Konzentrationsabhangigkeit und Homogenitat der Substanzverteilung experimentell zu untersuchen. Dazu wurden Operationspraparate lokal mit Photofrin II ohne zusatzliche Tragersubstanz inkubiert und postoperativ fluoreszenz-mikroskopische Auswertung an Gefrierschnitten durchgefuhrt.

Variability of the valve area calculated by the Gorlin formula has been noted in bioprosthetic and aortic valves, but few data are available for native stenotic mitral valves. Valve resistance has been proposed as an alternative hemodynamic indicator; however, its value in mitral stenosis has not been assessed. Thirty-four patients had simultaneous recordings of left atrial and ventricular pressures, 26 after percutaneous balloon mitral dilatation (PBMD). Patients with shunt or mitral regurgitation were excluded. Mitral valve resistance correlated exponentially with Gorlin mitral area (y = 133*[area]-1.5; p less than 0.0001). Both Gorlin mitral area and mitral resistance improved after PBMD (0.89 +/- 0.07 cm2 to 2.22 +/- 0.15 cm2; p less than 0.001; and 166 +/- 20 to 40 +/- 8 dynes.s.cm-5; p less than 0.001). Gorlin area and mitral resistance correlated with New York Heart Association functional class. After infusion of isoproterenol in 17 patients, there was an increase in Gorlin area (baseline 1.77 +/- 0.22 cm2, change 0.23 +/- 0.10; p less than 0.03), whereas mitral resistance did not change (baseline 96 +/- 16 dynes.s.cm-5, change 2 +/- 5; p = not significant). Mitral resistance is valuable in the assessment of mitral stenosis. It varies less than Gorlin mitral area under changing hemodynamic conditions.

The response of the human gynecological carcinoma cell-lines HEC-1-A (endometrial carcinoma) and OvCar-3 (ovarian carcinoma) to photodynamic therapy in vitro was examined. The porphyrin compound Photosan III (Ph III) was used for photosensitization of the cells after incubation times of 24 h (HEC-1-A) and 48 h (HEC-1-A and OvCar-3). The Ph III doses varied from 0-10 micrograms/ml medium. Irradiation was performed with laser light at 630 nm. Irradiation doses up to 20 J/cm2 were applied at an irradiance of 40-100 mW/cm2. Cell vitality of the untreated control groups and of the therapy group was determined 48 h after irradiation, using the trypan blue exclusion test. The experimental results show that treatment of OvCar-3 cells with 10 J/cm2 resulted in a decrease in vitality dependent on photosensitizer dose (0-5 micrograms/ml, 48 h incubation time) but independent of the irradiance (40-100 mW/cm2). Complete cell death was observed after application of irradiation doses in the range of 5-20 J/cm2 combined with drug concentrations of 10-2.5 micrograms/ml, at a fixed incubation time of 48 h. HEC-1-A cells did not survive photodynamic therapy with 10 J/cm2 after incubation with 5 micrograms/ml for 48 h. After a shorter incubation time of 24 h, 10 micrograms/ml Ph III was necessary for the same effect. There was a maximum decrease in cell vitality when measured 48 h after irradiation. This was not improved at 72 h.