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Egg yolk (EY, control) is an essential ingredient of diluents for boar semen cryopreservation. Pasteurized egg yolk (PEY) reduces hygienic risks in processing and is easier to standardize. The aim of this study was to evaluate the in vitro effect of PEY (treatment) on frozen-thawed boar semen. In a split-sample approach (n = 13 boars), it could be shown that there is neither an influence (p > .05) on post-thawing motility (PTM: 5, 30 and 120 min) nor on morphologically intact sperm, percentage of acrosome defects and membrane fluidity using a PEY extender compared to the control. Mitochondrial activity (p = .043), membrane integrity (p = .015) and PTM 300 min (p = .023) were slightly affected in the treatment group. Overall, sperm quality was at a high level in both experimental groups. Further studies are needed to determine the impact of PEY on the fertilizing capacity of boar ejaculates.

Background Polymeric heart valves are constructed from flexible synthetic materials, therefore aiming to combine the advantageous hemodynamic of biological and the longevity of mechanical valve prostheses. One such valve prototype in development is the PIZZA valve constructed of flexible triangular silicone leaflets on a foldable metal base for perspective transcatheter implantation. Here we present further improvements in its performance through structural modifications. Methods Structurally modified prototypes were constructed from silicone sheets and stainless-steel wires. Their performance was then tested in a hemodynamic testing device of the type HKP 2.0. Results Shift from a planar to a cone shape as well as overlapping of the leaflets significantly improved the valves performance, reducing regurgitation as well as systolic pressure gradients. Conclusions The results of the modified prototypes expressed superior performance and represented a step forward on the road to an easily producible, polymeric transcatheter valvular prosthesis.

Besides classical semen parameters, semen stress tests (SSTs) are helpful tools to assess the fertilizing capacity of sperm. However, valid studies on SSTs in relation to fertility are rare because several corrections of common fertility parameters for female and male effects are required. Therefore, over a one-year period, we analyzed semen parameters of 260 ejaculates obtained from 130 Pietrain boars aged between 8 and 9 months in one AI center as well as 1521 corresponding insemination records for these ejaculates. Two consecutive ejaculates (4th and 5th) were collected from each boar and extended in DiluPorc™ BTS. In addition to routine semen evaluation, sperm motility was assessed after heat-resistance test (300 min incubation at 38 °C after seven days storage at 16 °C, HRT) and cold-resistance test (10 min incubation at 38 °C after three days storage at 6 °C, CRT). Generalized linear models (GLMs) were applied to analyze effects for the following predictors of farrowing rate (FR), number of total born (NTB) and live born (NLB) piglets: farm (P = 0.013 [FR], P = 0.001 [NTB], P = 0.023 [NLB]), parity (P = 0.679, P = 0.01, P 0.001), weekday (P = 0.012, P = 0.08, P = 0.009) and year × season (P 0.001, P = 0.688, P = 0.574). On boar level, GLMs revealed significant effects on FR, NTB and NLB for the predictors sow (all P 0.001), total sperm number per dose (P = 0.007, P = 0.002, P 0.001), total sperm motility (P = 0.002, P = 0.2, P = 0.003) and mitochondrial activity (P = 0.004, P 0.001, P = 0.002). Moreover, FR and NTB were influenced by membrane integrity (both P 0.001), FR and NLB by cold-resistance (P 0.001, P = 0.043), and NTB and NLB by sperm morphology (P = 0.001, P 0.001) and boar (both P 0.001). NLB was additionally influenced by heat-resistance (P = 0.004) and farm (P = 0.018) and solely NTB was influenced by sperm output (P = 0.03). Boar and semen related factors explained 9% of the total variation in NTB and 7% of the total variation in NLB. Only 14.2% (n = 37) of the samples were both cold- and heat-resistant (≥65% of motile sperm). Cold- and heat-resistance were dependent factors (Chi-square, P = 0.001) and sperm motility after CRT and HRT showed a moderate positive correlation (r

The conventional storage temperature of 16-18 °C provides optimal conditions for the preservation of boar sperm quality, which are extremely cold sensitive cells. On the other hand, however, it requires the addition of antibiotics to inhibit bacterial growth. Rising numbers of antibiotic resistant bacteria call for alternatives to this conventional storing method. As potential alternative, three different bacteriocin candidates with known bacteriolytic activity against E. coli were examined on possible negative effects concerning the sperm quality and on their impact on bacterial growth of E. coli ILSH 02692 in BTS-extended semen w/o antibiotics. Although the lower concentrations (0.01 and 0.25%) of all bacteriocins did not show any impact on the quality of the semen, the higher concentrations (0.5 and 1.0%) of two bacteriocins led to a significant (P 0.05) reduction in several sperm quality characteristics. The bacteriocin 860/1c after AMS/dialysis did not affect the sperm quality in any of the tested concentrations and in all tested extenders (BTS, MIII, Androstar Premium and Androhep all w/o antibiotics) at 16 °C as well as at 6 °C. This bacteriocin reduced growth of E. coli ILSH 02692 in BTS-extended semen by 50% compared to the control w/o bacteriocin. Furthermore, a preliminary insemination trial indicated no impact of the selected bacteriocin on fertility. These promising results show that the application of bacteriocins in liquid-preserved semen is a feasible possibility in the future.

Extracorporeal circulation (ECC) is an integral part of cardiac surgery. Yet, the contact with artificial surfaces, mechanical stress, shear, and suction forces within the ECC pose a pronounced risk for damaging the corpuscular components of the blood. These suction forces may be reduced by a repositioning of the roller pumps employed below the reservoir. Furthermore, the repeated compression of the involved silicone tubing is likely to cause degradation. We present our observations regarding changes in the ECC performance following this degradation process. In vitro experiments were performed in a standard as well as a simplified ECC setup and included measurements of pressure, effective flow, and tubing restoring force over a time frame of 12 hours with two different pump positions utilizing transit time flow measurement. Suction forces within the tubing could be significantly reduced by shifting the pump position below the reservoir. Regardless of the setup, the tubing showed significant loss of restoring force as well as effective flow over time. A shift of the pump position within the ECC setup can be recommended to prevent blood damaging negative pressures. Further research is necessary to evaluate the exact cause of the reduction of restoring force overtime as well as its risks for the patients. Finally, our results underline the importance of transit time flow measurements to collect reliable flow data.

Antimicrobial resistance is a steadily increasing problem and poses a serious threat to global public health. Therefore, it is highly necessary to advance the development of novel antimicrobial compounds and semen preservation strategies. The aim of this study was to evaluate a low temperature, antibiotic-free preservation procedure using Androstar Premium (ASP) extender (Minitüb) with antimicrobial lipopeptides. Firstly, seven lipopeptides in two concentrations (1 × minimum inhibitory concentration (MIC)/2 × MIC) were tested on their sperm-compatibility at 17 °C. Two lipopeptides, C16-KKK-NH2 and C16-KKKK-NH2, did not negatively affect sperm quality and were further evaluated for their efficiency of bacterial growth inhibition at 5 °C. Besides an overall diminution of colony forming units, both peptides showed a reduction of bacterial subcultures (n = 103) with a decrement in Gram-positive rods from 65 (ASP w/o supplements) to 39/52 (ASP w/ C16-KKK-NH2/C16-KKKK-NH2), in Gram-positive cocci from 21 to 9/10 and in Gram-negative species from 17 to 8/5 total subcultures. Furthermore, lipopeptides revealed activity towards selected bacteria of potential concern in artificial insemination like Trueperella pyogenes, Alcaligenes faecalis, Pseudomonas aeruginosa (not C16-KKK-NH2), Pasteurella sp., Providencia stuartii, Escherichia coli (not C16-KKKK-NH2) and Streptococcus porcinus (not C16-KKKK-NH2). Consequently, both tested lipopeptides are promising candidates for alternative antibiotic-free preservation techniques of boar semen.

Aus der fortschreitenden Entwicklung informationstechnischer Kommunikation zur Vernetzung aller Prozesse im Werkzeuglebenszyklus und der Technologie zur Prozessbeobachtung ergeben sich neue Potenziale zur Systemeffizienzsteigerung des Werkzeugwesens. Zur Identifikation der Verbesserungspotenziale bedarf es eines lebenszyklusorientierten Ansatzes zur Analyse des Materialflusses und der Informationsverarbeitung. Der Aufsatz stellt eine Erweiterung der Wertstrommethode vor. The progressive development of information technology and process monitoring systems opens up new opportunities for increasing the efficiency of tool life cycle systems. To identify potential areas for improvement, a life cycle-oriented approach is needed to analyze the material flow and the processing of information. This paper presents an extension of the value stream mapping method.

Several domestic and wildlife species have been shown to possess antibacterial defenses in their ejaculate most probably in order to increase the fertilization success and protect against sexually transmitted pathogens. However, very little is known about the consequences and factors influencing the differences within and between species as far as ejaculate-associated immunity. In the present study, we have analyzed bacterial killing activity (BKA) against Escherichia (E.) coli and Staphylococcus (S.) aureus as well as lysozyme concentrations (LC) in seminal plasma from 60 Fleckvieh bulls. Further, sperm quality and its association with BKA and LC were determined. Twenty percent of the individuals displayed BKA against both bacteria, 78.3% against S. aureus only and 1.7% of the bulls did not indicate any BKA in seminal plasma. No bulls with seminal plasma BKA only against E. coli were identified; implying that 80.0% of the tested bulls had no ejaculate associated defense mechanisms against this gram-negative bacterial species in place. This is in striking contrast to results of Pietrain boars within our previous study, in which 42.8% of the 119 boars expressed an antibacterial activity against E. coli in seminal plasma, 10.9% amongst them with BKA against E. coli only. LC was higher in the bull group with BKA against both bacteria (1.2 ± 0.6 μg/mL) compared to the group with BKA against S. aureus only (0.7 ± 0.3 μg/mL), but – if calculated over all individuals – LC in bulls (0.8 ± 0.4 μg/mL) was lower compared to boars (2.4 ± 1.2 μg/mL). LC showed positive correlations to the age of the bulls and sperm quality as well as a negative relation to bacterial load in raw semen although the highest bacterial contamination was found in animals with seminal plasma BKA against both strains. We discuss the obtained results with regards to possible differences within the microbiome of female and male genital tracts and the reproductive strategies (vaginal vs. uterine depositors) in these two livestock species. Besides identifying the responsible molecules, future phylogenetically controlled comparative studies are needed for a better understanding of the evolution of species differences in ejaculate-associated antibacterial defenses.

Background Prosthetic replacement of aneurysms of the ascending aorta is the gold standard in terms of long-term stability. Wrapping seems to be a less invasive procedure. It has not yet been shown if it is as safe in terms of long-term outcome. Methods We present a single-center analysis of our experience over 13 years. We retrospectively analyzed data from patients who received either aortic prosthetic wrapping (AW) or aortic prosthetic replacement (AR) with or without aortic valve replacement and assessed them through phone calls. We used propensity score matching to adjust the baseline of the groups. Results Before propensity matching, 144 patients received AW and 91 patients underwent AR. Mean age was 64 ± 11.8 years. After propensity score matching and adjusting for significant differences in age, gender, body mass index, logistic EuroSCORE I, and left ventricular function, 69 patients in each group remained for further analysis. Rate of early reoperation due to tamponade, inhospital mortality, and survival rates did not differ. In both groups, the surgically treated aortic segment did not show enlargement, whereas the nontreated aortic arch showed comparable aneurysmatical progression. Conclusions AW is safe and feasible and can be used in elderly or frail patients in order to avoid an AR. Progression of the remaining native aortic segments occurs, thus requiring strict life-long follow-up to ensure an elective and thus safe approach for appropriate consecutive surgical measures, if required.

The frequent use of antibiotics in artificial insemination promotes the development of antibiotic resistance. Therefore, alternatives must be considered. In this study, putative bioactive microalgae and hop extracts were examined to estimate their effect on quality and bacterial load of preserved porcine semen when used a low-temperature storage at 5 °C in Androstar® Premium (ASP) extender (Minitub). Firstly, five algae extracts (Neochloris oleoabundans (NEO), Pseudococcomyxa simplex (PSEY), Phormidium ambiquum (PHA), Schizochlamydella minutissima (SCH), Cyanidioschyzon merolae (CYA)) and one hop extract (Humulus lupulus (HOP)) in four concentrations (0.2, 2, 20 and 200 μg/mL) were tested on their sperm-compatibility at 17 °C. All extracts in the concentrations 0.2 and 2 μg/mL appeared to be sperm compatible. After 72 h of storage at 5 °C, variants showed an increase of total bacterial subcultures from 103 (ASP w/o supplements) to 113/136/135/136/126/118 (ASP w/NEO/PSEY/PHA/HOP/SCH/CYA). Even though bacterial growth was not inhibited in general, all extracts showed an antimicrobial effect on specific bacteria, including Gram-positive (Trueperella pyogenes, Streptococcus porcinus) and Gram-negative bacterial species (Alcaligenes faecalis, Pseudomonas aeruginosa, Ralstonia sp., Pasteurella sp., Proteus sp., Providencia stuartii, and Escherichia coli). While the proportion of these species was 10% in the control (ASP w/o supplements), their proportion in the supplemented variants ranged from 8% (NEO, HOP) to as low as 3% (PSEY). Although the tested extracts are not suitable to replace conventional antibiotics due to their lack of broad-spectrum antimicrobial activity, they nevertheless present promising opportunities for bacteria-specific, customizable usage in boar semen extenders combined with antibiotics or other antimicrobial agents.

Die Apophysen als sekundare Ossifikationszentren sind mittels einer Knorpelfuge mit dem Knochen verbunden. Wahrend der Wachstumsphase in der Pubertat stellt die Apophysenfuge eine mechanische Schwachstelle dar. Besonders die Apophysen im Huft- und Beckenbereich sind durch die hier ansetzende kraftige Muskulatur erheblichen Zug- und Scherbelastungen ausgesetzt. Die Haufigkeit solcher Apophysenschadigungen korreliert mit dem Ausmas der sportlichen Aktivitaten. Bei den Sportlern, die bei „Jugend trainiert fur Olympia“ teilnehmen, handelt es sich um die haufigste Verletzung uberhaupt. Am haufigsten ist die Apophyse des M. rectus femoris an der Spina iliaca anterior inferior betroffen. Im Erwachsenenalter, also nach einer kompletten Verknocherung der Apophysenfugen sind solche Verletzungen selten anzutreffen. Bei einem ganz ungewohnlichen Verletzungsmechanismus mit einer maximal erzwungenen Huftanbeugung bei gleichzeitiger maximaler Kniestreckung werden jedoch bei Erwachsenen Ausrisse am Tuber ossis ischii beobachtet. Bei der Kausalitatsprufung – besonders im Rechtsbereich der gesetzlichen Unfallversicherung – stellt sich stets die Frage, ob der angeschuldigte Hergang als rechtlich wesentliche (Teil-)Ursache anzusehen ist oder ob es sich um eine mehrzeitig, dann also uberwiegend schicksalhaft entstandene krankhafte Apophysenablosung gehandelt hat, bei der das angeschuldigte Ereignis als rechtlich unwesentlich zu interpretieren ist.

The (re)organization of membrane components is of special importance to prepare mammalian sperm to fertilization. Establishing suitable methods to examine physico-chemical membrane parameters is of high interest. We characterized the behavior of fluorescent (NBD) analogs of sphingomyelin (SM), phosphatidylserine (PS), and cholesterol (Ch) in the acrosomal and postacrosomal macrodomain of boar sperm. Due to their specific transverse membrane distribution, a leaflet-specific investigation of membrane properties is possible. The behavior of lipid analogs in boar sperm was investigated by fluorescence lifetime imaging microscopy (FLIM), fluorescence recovery after photobleaching (FRAP), and fluorescence correlation spectroscopy (FCS). The results were compared with regard to the different temporal and spatial resolution of the methods. For the first time, fluorescence lifetimes of lipid analogs were determined in sperm cell membrane and found to be in a range characteristic for the liquid-disordered phase in artificial lipid membranes. FLIM analyses further indicate a more fluid microenvironment of NBD-Ch and NBD-PS in the postacrosomal compared to the acrosomal region. The concept of a more fluid cytoplasmic leaflet is supported by lower fluorescence lifetime and higher average D values (FCS) for NBD-PS in both head compartments. Whereas FLIM analyses did not indicate coexisting distinct liquid-ordered and -disordered domains in any of the head regions, comparisons between FRAP and FCS measurements suggest the incorporation of NBD-SM as well as NBD-PS in postacrosomal subpopulations with different diffusion velocity. The analog-specific results indicate that the lipid analogs used are suitable to report on the various physicochemical properties of different microenvironments.

Zielstellung und Hypothese: Anliegen dieses systematischen Review mit anschliesender Metaanalyse war es, den Einfluss des aktiven Fusballsports auf das Kniearthroserisiko (Relevanz als Berufserkrankung) zu untersuchen. Als Hypothese wurde formuliert: Fusballer leiden auch dann unter einem erhohten Risiko fur eine Gonarthrose, wenn sie keine dokumentierten Makroverletzungen des Kniegelenks erlitten haben. Methode: Fur das systematische Literaturreview und die anschliesende Metaanalyse wurden die PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Checklisten eingehalten. Zum Stichtag 1.2.2014 wurde eine systematische Recherche in den Datenbanken PubMed, Medline, Cochrane, EMBASE und Web-of-Science durchgefuhrt. Insgesamt 4649 Publikationen einem „Title-Abstract-Review“ unterworfen und schlieslich 6 Publikationen in die Metaanalyse eingeschlossen. Ergebnisse: Eine Langsschnittuntersuchung an einer Gesamtbevolkerung, die den Einfluss des Fusballsports auf das Gonarthroserisiko untersuchte, wurde nicht gefunden. Ein systematisches Cochrane-Review existierte ebenso nicht. In den Studien, in denen nur diejenigen Falle berucksichtigt wurden, bei denen keine Makroverletzung stattgefunden hatte, bestand im Vergleich zu den jeweiligen Kontrollgruppen ein signifikant erhohtes Risiko, eine Gonarthrose zu erleiden: 1,3 (95 % CI 1,0 – 1,7); I2 = 37,4 %; p = 0,002. Ohne Adjustierung auf dokumentierte Makroverletzungen oder einen Meniskusschaden haben Fusballer ein signifikant erhohtes Gonarthroserisiko: (Relatives Risiko = 2,9 [95 % CI 2,0 – 4,1]; I2 = 56,3 %; p Schlussfolgerungen: Im Hinblick auf die grose Heterogenitat der Belastung des Fusballerknies, aufgrund des Fehlens der Kenntnis uber ein belastungskonformes Schadensbild und im Hinblick auf das Fehlen einer „Verdopplung des relativen Risiko in der exponierten Gruppe“ wird derzeit keine „BK-Reife“ und auch kein Tatbestand „wie-BK“ bezuglich der Gonarthrose beim Profifusballer gesehen.

Hintergrund Die Kommunikation zwischen Arzt und Patient stellt eine unverzichtbare Saule fur die gutachtliche Beurteilung dar. Ohne Kommunikation – nicht zuletzt auch mit dem Auftraggeber des Gutachtens – ware eine gutachtliche Sachverhaltsuberprufung nicht moglich.

AWN is a porcine (Sus scrofa domestica) seminal plasma protein and has been linked to a variety of processes related to fertilization. To acquire the protein in sufficient amount and purity for functional studies, we established its recombinant expression in E. coli and a three-step purification protocol based on different chromatographies. The test for AWN-phospholipid interaction revealed phosphatidic acid and cardiolipin as potential binding partners. As phosphatidic acid is surmised to play a role in cation-induced membrane destabilization and fusion events, we propose a membrane protective function of the presented binding affinity. Further studies with recombinant AWN will allow new insights into the mechanism of sperm-spermadhesin interaction and might provide new approaches for artificial reproduction techniques.

P-selectin ligands (P-ligs) support the recruitment of lymphocytes into inflamed tissues. Binding to P-selectin is mediated by oligosaccharide groups synthesized by means of several glycosyltransferases including core 2 s1,6-N-acetylglucosaminyltransferase-I (C2GlcNAcT-I), encoded by the gene Gcnt1. Using Gcnt1(-/-) Th1 cells, we show that C2GlcNAcT-I is crucial for inflammatory T cell homing in vivo. To understand the molecular regulation of Gcnt1 in CD4(+) T helper cells, we performed ChIP-on-chip experiments across the Gcnt1 locus assessing the chromatin structure in P-lig-expressing versus non-expressing CD4(+) T cells. This identified a distal region about 20kb upstream of the promoter where the presence of a H3K27me3 mark correlated with Gcnt1 repression. This region possessed IL-12-dependent enhancer activity in reporter assays, in accordance with preferential IL-12-dependent induction of Gcnt1 in vitro. STAT4 and T-bet cooperated in control of the enhancer activity. Deficiency in either one resulted in drastically reduced Gcnt1 mRNA expression in differentiated Th1 cells. While both STAT4 and T-bet were bound to the enhancer early after activation only T-bet binding persisted throughout the expansion phase after TCR signal cessation. This suggests sequential action of STAT4 and T-bet at the enhancer. In summary, we show that Gcnt1 transcription and subsequent P-lig induction in Th1 cells is governed by binding of STAT4 and T-bet to a distal enhancer and further regulated by epigenetic marks such as H3K27me3.

Trotz jahrzehntelanger wissenschaftlicher Bemuhungen ist es bis zum heutigen Tage nicht gelungen, den von Crowe [6] im Jahr 1928 gepragten Begriff des „Schleudertraumas“ (engl. „whiplash“) mit Inhalt, also einem klar definierten Verletzungsbild eigener Entitat zu fullen. Die Diskussion ist bisher uber hypothetische Ansatze nicht hinausgekommen, und diese besonders fur die Betroffenen so eindrucksvolle Begrifflichkeit somit inhaltsleer geblieben. Diese klaffende Lucke gab genugend Raum fur vielfaltige hypothetische Erklarungen, warum die Beschwerden bei einem Teil der betroffenen Personen trotz anfanglich fehlender objektiver Verletzungsmerkmale ubergehen in ein chronifizierendes subjektives Beschwerdebild, welches nur allzu haufig in eine ausufernde haftpflicht-rechtliche Auseinandersetzung – nicht zuletzt gestutzt mit nachhaltigen arztlichen Attestierungen und ganz unterschiedlichen gutachtlichen Beurteilungen – einzumunden pflegt. Im nachfolgenden Beitrag werden die wesentlichsten dieser Hypothesen samt ihrer historischen Wurzeln thematisiert. Im Weiteren wird aufgezeigt, wie vor dem Hintergrund beweisrechtlicher Vorgaben, aber auch gesicherter pathophysiologischer Erkenntnisse der Heilung die Kausalitatsfrage in einer nuchternen analytischen Betrachtungsweise beantwortet werden kann.

Mit dem Begriff der Kausalitat wird das philosophische Konstrukt umschrieben, dass jede Veranderung eine Ursache hat, die eine Wirkung hervorruft. Dennoch kann ein scheinbar einfacher Kausalitatsverlauf, gedanklich abgestellt auf repetitive Erfahrungen zu einem vermeintlich „naturgesetzlichen“ Zusammenhang, einer Sinnestauschung unterliegen, nicht selten auch verknupft mit einer Nichtbeachtung beweisrechtlicher Regeln. Unterschiedliche Rechtsnormen konnen einen solchen Prufungsvorgang so weit beeinflussen, dass am Ende der Kausalitatsprufung z. B. im Bereich der privaten Versicherung ein anderes Ergebnis steht als in einem Prufungsverfahren im sozialrechtlichen Bereich. Gleichermasen bestehen Unterschiede im sozialrechtlichen Prufungsverfahren zur Kausalitat einer Gesundheitsstorung einerseits nach einer Unfalleinwirkung und andererseits nach beruflichen Einwirkungen. Diese Unterschiede in der Kausalitatsprufung im Sozialversicherungsrecht (gesetzliche Unfallversicherung) werden vergleichend betrachtet. Hierbei werden Besonderheiten aufgezeigt, deren Unkenntnis oder Nichtbeachtung unweigerlich zu fehlerhaften Expertisen fuhren mussen.

The apophyses as secondary ossification centers are connected with the bone by cartilage. During the growth phase of puberty, the apophyseal plate is a mechanical weak spot. Especially, apophyses in the hip and pelvic area are exposed to considerable tensile and sheer stresses due to the strong muscles which are inserted here. The frequency of injuries to the apophyses correlates with the extent of sporting activities. For athletes participating in "Youth Train for the Olympics", this is the most common injury of all. Most often, the apophysis of the rectus femoris muscle is affected at the anterior inferior iliac spine. In adults, after complete ossification of the apophyseal plate such injuries are rare. However, in a very unusual mechanism of injury with maximum forced hip flexion and simultaneous maximum knee extension, avulsions of the ischial tuberosity are observed in adults. During the causality test-especially in the legal area of statutory accident insurance-the question is always whether the alleged course of events has to be regarded as a legally significant (partial) cause or if a longer period of time has been involved, so that the resulting morbid apophysis detachment was predominately due to fate, in which the alleged event must be interpreted as legally immaterial.

Sinn und Zweck der Beauftragung eines medizinischen Sachverstandigen ist es, dem Auftraggeber die Subsumtion (Einordnung) eines tatsachlichen Geschehensablaufes unter rechtlichen Bestimmungen zu ermoglichen, seien es solche mit Gesetzescharakter (z. B. Sozialgesetzbucher, Schadenersatznorm etc.) oder Versicherungsbedingungen. Inhalt eines Sachverstandigengutachtens konnen und durfen nur Wertungen und Schlussfolgerungen sein, welche der medizinische Sachverstandige aufgrund seines besonderen – dem Auftraggeber fehlenden – Fachwissens zu treffen hat. Es ist daher eine unabdingbare Voraussetzung, dass der Auftraggeber dem Sachverstandigen die zu beantwortenden Fragen so konkret und dezidiert stellt, dass der Sinn und Zweck der gutachtlichen Uberprufung eindeutig erscheint. Der beauftragte arztliche Sachverstandige kann den Auftrag nur mit einer solchen Konkretisierung der Fragestellungen in Kenntnis des aktenkundigen Sachverhaltes erfullen.

Die arztlich-medizinische Begutachtung im Leistungswesen der gesetzlichen Unfallversicherung verlangt einerseits eine sich im Gutachtenauftrag widerspiegelnde solide Aufbereitung des gutachtlich zu klarenden Sachverhaltes seitens der Verwaltung, andererseits eine nicht nur von fachmedizinischer, sondern auch gutachtlicher Kompetenz getragenen Sachverstandigentatigkeit, ohne die die Versicherungstrager ihren gesetzlichen Auftrag nicht hinreichend erfullen konnen. In letzter Konsequenz sind die gutachtlichen Expertisen unverzichtbar, um sozialrechtliche Vorgaben, also den Sozialstaat zu verwirklichen.

Seit ihrem Inkrafttreten Anfang 1993 haben die Berufskrankheiten Nr. 2108 und 2110 (bandscheibenbedingte Erkrankungen der Lendenwirbelsaule durch langjahrige[s] Heben oder Tragen schwerer Lasten, Tatigkeiten in extremer Rumpfbeugehaltung oder Ganzkorperschwingungen im Sitzen, die zur Unterlassung aller Tatigkeiten gezwungen haben, die fur die Entstehung, die Verschlimmerung oder das Wiederauftreten der Krankheit ursachlich waren oder sein konnen) erhebliche Umsetzungsprobleme bereitet. Als Ergebnisse einer interdisziplinaren Arbeitsgruppe werden mit dem vorliegenden Teil I des Beitrags zunachst medizinische Beurteilungskriterien zum belastungskonformen Krankheitsbild und zur Bewertung moglicher Konkurrenzursachen dargestellt. In Heft 4/2005 folgt Teil II, der sich mit Fragen des Unterlassungszwangs sowie der Einschatzung der MdE beschaftigen wird. Die vorgestellten Arbeitsergebnisse sollen auf der Grundlage des in weiten Teilen erzielten Konsenses zur wissenschaftlich fundierten, einheitlichen Begutachtung von LWS-Erkrankungen beitragen, bei denen die Fragen des Vorliegens einer berufsbedingten Bandscheibenerkrankung und deren Auswirkungen zu beurteilen sind.

Besonderheiten in der Begutachtung von Sehnenschaden in der privaten- und in der gesetzlichen Unfallversicherung werden dargestellt.