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In order to make accurate inferences about the solar interior using helioseismology, it is essential to understand all the relevant physical effects on the observations. One effect to understand is the (complex-valued) ratio of the horizontal to vertical displacement of the p- and f-modes at the height at which they are observed. Unfortunately, it is impossible to measure this ratio directly from a single vantage point, and it has been difficult to disentangle observationally from other effects. In this paper we attempt to measure the ratio directly using 7.5 hours of simultaneous observations from the Polarimetric and Helioseismic Imager on board Solar Orbiter and the Helioseismic and Magnetic Imager on board the Solar Dynamics Observatory. While image geometry problems make it difficult to determine the exact ratio, it appears to agree well with that expected from adiabatic oscillations in a standard solar model. On the other hand it does not agree with a commonly used approximation, indicating that this approximation should not be used in helioseismic analyses. In addition, the ratio appears to be real-valued., Comment: Accepted for publication in Astronomy & Astrophysics. 8 pages, 8 figures

Das umfassende arthroskopische Management („comprehensive arthroscopic management“, CAM) der symptomatischen glenohumeralen Arthrose kann die Notwendigkeit zur Implantation einer endoprothetischen Versorgung hinauszogern. Vor dem Hintergrund tendenziell schlechter Ergebnisse von Schulterprothesen in einem jungen Patientengut unter 55 Jahren kann diese minimal-invasive Technik eine Therapiealternative zur Prothese darstellen.

Full list of authors: Kahil, F.; Hirzberger, J.; Solanki, S. K.; Chitta, L. P.; Peter, H.; Auchère, F.; Sinjan, J.; Orozco Suárez, D.; Albert, K.; Albelo Jorge, N.; Appourchaux, T.; Alvarez-Herrero, A.; Blanco Rodríguez, J.; Gandorfer, A.; Germerott, D.; Guerrero, L.; Gutiérrez Márquez, P.; Kolleck, M.; del Toro Iniesta, J. C.; Volkmer, R. ; Woch, J.; Fiethe, B.; Gómez Cama, J. M.; Pérez-Grande, I.; Sanchis Kilders, E.; Balaguer Jiménez, M.; Bellot Rubio, L. R.; Calchetti, D.; Carmona, M.; Deutsch, W.; Fernández-Rico, G.; Fernández-Medina, A.; García Parejo, P.; Gasent-Blesa, J. L.; Gizon, L.; Grauf, B.; Heerlein, K.; Lagg, A.; Lange, T.; López Jiménez, A.; Maue, T.; Meller, R.; Michalik, H.; Moreno Vacas, A.; Müller, R.; Nakai, E.; Schmidt, W.; Schou, J.; Schühle, U.; Staub, J.; Strecker, H.; Torralbo, I.; Valori, G.; Aznar Cuadrado, R.; Teriaca, L.; Berghmans, D.; Verbeeck, C.; Kraaikamp, E.; Gissot, S.-- This is an Open Access article, published by EDP Sciences, under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., Context. The Extreme Ultraviolet Imager (EUI) on board the Solar Orbiter (SO) spacecraft observed small extreme ultraviolet (EUV) bursts, termed campfires, that have been proposed to be brightenings near the apexes of low-lying loops in the quiet-Sun atmosphere. The underlying magnetic processes driving these campfires are not understood. Aims. During the cruise phase of SO and at a distance of 0.523 AU from the Sun, the Polarimetric and Helioseismic Imager on Solar Orbiter (SO/PHI) observed a quiet-Sun region jointly with SO/EUI, offering the possibility to investigate the surface magnetic field dynamics underlying campfires at a spatial resolution of about 380 km. Methods. We used co-spatial and co-temporal data of the quiet-Sun network at disc centre acquired with the High Resolution Imager of SO/EUI at 17.4 nm (HRIEUV, cadence 2 s) and the High Resolution Telescope of SO/PHI at 617.3 nm (HRT, cadence 2.5 min). Campfires that are within the SO/PHI−SO/EUI common field of view were isolated and categorised according to the underlying magnetic activity. Results. In 71% of the 38 isolated events, campfires are confined between bipolar magnetic features, which seem to exhibit signatures of magnetic flux cancellation. The flux cancellation occurs either between the two main footpoints, or between one of the footpoints of the loop housing the campfire and a nearby opposite polarity patch. In one particularly clear-cut case, we detected the emergence of a small-scale magnetic loop in the internetwork followed soon afterwards by a campfire brightening adjacent to the location of the linear polarisation signal in the photosphere, that is to say near where the apex of the emerging loop lays. The rest of the events were observed over small scattered magnetic features, which could not be identified as magnetic footpoints of the campfire hosting loops. Conclusions. The majority of campfires could be driven by magnetic reconnection triggered at the footpoints, similar to the physical processes occurring in the burst-like EUV events discussed in the literature. About a quarter of all analysed campfires, however, are not associated to such magnetic activity in the photosphere, which implies that other heating mechanisms are energising these small-scale EUV brightenings. © F. Kahil et al. 2022., Solar Orbiter is a space mission of international collaboration between ESA and NASA, operated by ESA. We are grateful to the ESA SOC and MOC teams for their support. The German contribution to SO/PHI is funded by the BMWi through DLR and by MPG central funds. The Spanish contribution is funded by FEDER/AEI/MCIU (RTI2018-096886-C5), a “Center of Excellence Severo Ochoa” award to IAA-CSIC (SEV-2017-0709), and a Ramón y Cajal fellowship awarded to DOS. The French contribution is funded by CNES. The EUI instrument was built by CSL, IAS, MPS, MSSL/UCL, PMOD/WRC, ROB, LCF/IO with funding from the Belgian Federal Science Policy Office (BELSPO/PRODEX PEA 4000112292); the Centre National d’Etudes Spatiales (CNES); the UK Space Agency (UKSA); the Bundesministerium für Wirtschaft und Energie (BMWi) through the Deutsches Zentrum für Luft- und Raumfahrt (DLR); and the Swiss Space Office (SSO).

Las audioprotesis amplificadoras por via no aerea se distinguen de las audioprotesis convencionales que utilizan la via aerea del conducto auditivo externo. Se utilizan otras dos vias de estimulacion: la conduccion osea, como los vibradores externos, asi como una estimulacion osea directa mediante las protesis implantadas estan indicadas en algunas sorderas de transmision o mixtas, asi como en las sorderas unilaterales; la estimulacion directa al nivel de los huesecillos o de la ventana redonda mediante los implantes de oido medio permite ampliar las indicaciones a ciertas sorderas neurosensoriales y de transmision o mixtas. En este articulo se presentan la descripcion, las indicaciones y los resultados de cada audioprotesis por via no aerea.

The biceps-labrum complex is prone to acute lesions and degenerative changes due to its anatomical structure and the high load it has to endure. Pathological changes of these structures are common pain generators and can significantly impair shoulder function. Anatomically, the biceps-labrum complex can be divided into three zones: inside, junction and bicipital tunnel.Despite the focused physical examination and advancements in imaging techniques, the exact localization of pathologies remains challenging. Arthroscopy can be used to accurately diagnose inside and junctional pathologies but extra-articular changes in the region of the bicipital tunnel can only be partially visualized.In cases of unsuccessful conservative treatment and correct indications, a high level of patient satisfaction can be surgically achieved. In young patients an anatomical reconstruction of inside lesions or tenodesis of the long head of the biceps tendon is performed; however, even tenotomy is a valuable option and can achieve equally satisfactory results. Unaddressed pathological changes of the bicipital tunnel can lead to persistence of pain. In clinical procedures performing tenodesis, both the different techniques and the implants used have been found to show similar results. This article describes the anatomical principles, pathological changes, the focused clinical instrumental diagnostics and discusses the different treatment philosophies as well as the outcome according to the recent literature.HINTERGRUND: Der Bizeps-Labrum-Komplex ist aufgrund der anatomischen Gegebenheiten und der hohen Belastung anfällig für akute Läsionen und degenerative Veränderungen. Eine pathologische Veränderung dieser Strukturen stellt einen üblichen Schmerzgenerator am Schultergelenk dar und kann die Funktion signifikant reduzieren. Anatomisch kann der Bizeps-Labrum-Komplex in 3 Zonen eingeteilt werden: Ursprungsbereich, intraartikulärer Verlauf und Bereich im Bizepssehnentunnel.Trotz der fokussierten körperlichen Untersuchung und des Fortschritts der bildgebenden Verfahren verbleibt die exakte Lokalisierung der Pathologie eine Herausforderung. Durch eine Arthroskopie lassen sich v. a. Pathologien im Bereich des Ursprungs und im intraartikulären Verlauf gut diagnostizieren, jedoch nur partiell extraartikuläre Pathologien im Bereich des Bizepssehnentunnels.Bei Versagen der konservativen Therapie kann bei korrekter Indikationsstellung operativ eine hohe Patientenzufriedenheit erreicht werden. Während beim jungen aktiven Patienten rekonstruktive Verfahren und die Tenodese der langen Bizepssehne im Vordergrund stehen, lassen sich aber auch durch die Tenotomie hochgradig zufriedenstellende Ergebnisse erreichen. Nichtadressierte pathologische Veränderungen im Bereich des Bizepssehnentunnels können zu einer Schmerzpersistenz führen. In der klinischen Anwendung zur Durchführung der Tenodese zeigen sich sowohl die unterschiedlichen Techniken als auch die verwendeten Implantate als gleichwertig.Dieser Beitrag beschreibt die anatomischen Grundlagen, pathologische Veränderungen, die fokussierte klinisch-apparative Diagnostik und diskutiert die unterschiedlichen Behandlungsphilosophien und deren Ergebnisse anhand aktueller Literatur.

Magnetic resonance imaging (MRI) is routinely used for the diagnostic assessment of diseases of the shoulder joint. Depending on the clinical presentation native imaging, intravenous (IV) or intra-articular injection of contrast medium can be performed (MR arthrography). Advances in imaging technology nowadays enable early detection of characteristic changes in the clinical picture of frozen shoulder. These changes typically include thickening of the coracohumeral ligament, the axillary pouch and the capsule at the rotator interval. Furthermore, obliteration of the subcoracoidal fat pad can also be observed. The MRI examinations also show a hyperintensity in the T2-weighted imaging and a contrast enhancement of the joint capsule. The alterations can show a temporal correlation with the clinical symptoms of the patient.

The PROFHER study is a multicenter randomized controlled trial of 250 out of 1250 patients assessed for eligibility with dislocated proximal humeral fractures with involvement of the surgical neck. These patients were randomized either for surgery or conservative treatment. Patients with comorbidities that precluded surgery, lack of mental capacity, luxation fractures or clear indications for surgery from the authors' perspective were excluded. To evaluate the outcome, standardized self-assessment methods were used (patient reported outcome [PRO]), including the Oxford shoulder score (OSS). The results showed no differences in the primary and secondary self-assessment outcome scores after both 2 and 5 years. Although no significant differences could be detected between both groups, no clear statement could be deduced from the PROFHER study with respect to which patients would benefit from an operative treatment. Nevertheless, the PROFHER study provides a valuable and important addition to the literature on this heavily debated topic. The purpose of this review is to critically evaluate the PROFHER study within the existing literature regarding inclusion of patients, fracture treatment and evaluation of the results.

The torsion of the humerus describes the physiological rotation of the humerus around its longitudinal axis. Various clinical and radiological methods for measurement have been described. The computed tomography method is currently the gold standard. The angle between the humeral head axis and the transepicondylar axis is measured. This angle is called retroversion. Values of retroversion vary between 10° and 40°. For the treatment of many humeral pathologies, a precise reconstruction of the anatomical retroversion is required. The retroversion of the humerus has to be considered in shoulder arthroplasty, in fracture situations and also in planning correction of posttraumatic deformities. If an orientation to the original anatomical landmarks of the humerus is no longer possible, an orientation to the contralateral side is recommended.

The use of reverse shoulder arthroplasty (RSA) has increased dramatically over the last two decades, with many surgeons now indicating RSA for the acute management of displaced proximal humerus fractures (PHF) in the elderly. RSA relies on adequate deltoid muscle function to obtain a good outcome, yet no literature to date exists which discusses preoperative assessment of deltoid structure prior to RSA. The purpose of this study was to assess for preoperative fatty deltoid-degeneration in patients with displaced PHF.We reviewed the axial CT scans of 100 consecutive patients with a displaced PHF. Fatty degeneration within each of the three deltoid-heads was graded at three levels, according to Goutallier and colleagues. Fractures were classified according to Neer.Seventy-nine percent of the patients were female, 75% showed 3 or 4 parts fractures. The average cross-sectional area of the posterior deltoid was greatest-representing 37%, 40% and 42% of total area at each level, respectively. Severe fatty degeneration (Stages 3 and 4) was observed in the posterior deltoid only (26%). Absence of fatty degeneration (Stage 0) was observed in25% of cases. The Inter-Observer-Reliability for the continuous variables proved to be high.Preoperative deltoid fatty degeneration is common in displaced PHF in the elderly. Because CT is commonly obtained to assess fracture morphology and for preoperative planning purposes, it is an ideal tool to assess the deltoid additionally. Future studies are warranted to determine whether preoperative fatty infiltration of the deltoid correlates with mid and long term functional outcomes when RSA is used acutely to manage a PHF.Level IV-consecutive case series.

In contrast to shoulder dislocations in younger patients, anterior shoulder dislocation in the elderly is often associated with concomitant injuries to the rotator cuff and fractures. There is also frequent involvement of the brachial plexus or peripheral nerves. After closed reduction and a short period of immobilization, physiotherapy should be performed to restore mobility and strength. The evaluation of the rotator cuff is essential for further treatment decisions. The majority of patients are classically treated conservatively. Elderly patients with accompanying rotator cuff lesions and failed conservative therapy can benefit from a surgical intervention. Reconstructive interventions of the rotator cuff should be principally considered; however, some individuals may benefit from a reverse prosthesis in this elderly subgroup of patients. The challenge for the treating surgeon is to exactly define the structural injury of the shoulder (which may include pre-existing lesions) and to select the optimal treatment option.

EMC requirements for scientific satellites are usually very stringent and much more demanding than terrestrial standards, mainly because ad-hoc scientific instruments developed for the mission require very quiet electromagnetic environments to perform their science. These requirements will assure the compatibility of all instruments on board and with the platform. The electromagnetic noise generated by the DC/DC converter of the PHI instrument, to be flown on board Solar Orbiter, has been drastically reduced applying several different techniques. One technique has been to change the grounding strategy from a single point grounding to a distributed grounding. Two additional techniques were needed to reach the required noise floor. Experimental measurements show the improvements achieved with each technique.

SUNRISE is a balloon-borne solar telescope flown with a long-duration balloon by NASA's Columbia Scientific Balloon Facility team from Esrange (Swedish Space Corporation), on 8 June 2009. SUNRISE has been a challenging mission from the thermal point of view because of its size and power dissipation. Thus, a dedicated thermal analysis has been carried out to find a solution that allows all the devices to be kept within their appropriate temperature ranges, without exceeding the allowable temperature gradients, critical for optical devices. In this article, the thermal design of SUNRISE is described. A geometrical mathematical model and a thermal mathematical model of the whole system have been set up for the different load cases in order to obtain the temperature distribution and gradients in the system. Some trade-offs have been necessary to fulfil all the thermal requirements. The thermal hardware used to achieve it is described. Finally, the temperatures obtained with the models have been compared with flight data.

In der Versorgungskette unfallverletzter Patienten besteht neben den komplexen Behandlungsablaufen der jeweiligen Versorgungsabschnitte zusatzliches Gefahrdungspotenzial in den Schnittstellen der Versorgungsabschnitte. Neben einem nicht unerheblichen Zeit- und Informationsverlust konnen Inkompatibilitaten technischer Geratschaften, abweichende Behandlungskonzepte sowie Verantwortlichkeiten und letztlich die physikalische Umlagerung selbst den Patienten gefahrden. Dabei treten Schnittstellen sowohl zwischen praklinischer und klinischer Versorgung auf als auch innerhalb der jeweiligen Versorgungsabschnitte, z. B. praklinisch bei der Ubergabe vom boden- an den luftgebundenen Notarzt. Zielsetzung einer effizienten Versorgungskette muss es daher sein, Schnittstellen zu reduzieren, um die Prozessablaufe zu optimieren. Zukunftige Konzepte zur Prozessoptimierung in der Traumaversorgung sollten zur Schnittstellenreduktion beitragen.

The Optical, Spectroscopic, and Infrared Remote Imaging System OSIRIS is the scientific camera system onboard the Rosetta spacecraft (Figure 1). The advanced high performance imaging system will be pivotal for the success of the Rosetta mission. OSIRIS will detect 67P/Churyumov-Gerasimenko from a distance of more than 106 km, characterise the comet shape and volume, its rotational state and find a suitable landing spot for Philae, the Rosetta lander. OSIRIS will observe the nucleus, its activity and surroundings down to a scale of ~2 cm px−1. The observations will begin well before the onset of cometary activity and will extend over months until the comet reaches perihelion. During the rendezvous episode of the Rosetta mission, OSIRIS will provide key information about the nature of cometary nuclei and reveal the physics of cometary activity that leads to the gas and dust coma. OSIRIS comprises a high resolution Narrow Angle Camera (NAC) unit and a Wide Angle Camera (WAC) unit accompanied by three electronics boxes. The NAC is designed to obtain high resolution images of the surface of comet 67P/Churyumov-Gerasimenko through 12 discrete filters over the wavelength range 250–1000 nm at an angular resolution of 18.6 μrad px−1. The WAC is optimised to provide images of the near-nucleus environment in 14 discrete filters at an angular resolution of 101 μrad px−1. The two units use identical shutter, filter wheel, front door, and detector systems. They are operated by a common Data Processing Unit. The OSIRIS instrument has a total mass of 35 kg and is provided by institutes from six European countries. The support of the national funding agencies of Germany (DLR), France (CNES), Italy (ASI), Sweden (SNSB), and Spain (MEC) is gratefully acknowledged. Substantial support for the development of the Data Processing Unit was provided by the ESA Technical Directorate through the Technical Research Programme. In addition to the formal co-authors of this paper (comprising lead scientists, Co-Is, project managers, and lead engineers ), the project was supported by an enormous number of scientists, engineers, and technicians involved in the day-to-day development of the hardware. These include J. C. Blanc, D. Pouliquen, M. Saisse (France), A. Alvarez, A. L. Arteaga, A. Carretero, M. Fernández, H. Guerrero, P. Gutiérrez, J. L. Lizondo, V. Luengo, J. A. Martín, M. A. Martín, J. Meseguer, J. M. Mi, L. Moreno, J. Navarro, A. Núñez, E. Ragel, D. Rodríguez, G. Rosa, A. Sanchez, J. C. Sanmartín, G. Tonellotto (Spain), W. Boogaerts, W. Engelhardt, K. Eulig, B. Fiethe, A. Fischer, M. Gartner, K. Grabig, K. Kellner, A. Kiihn. W. Kiihn. J. Knollenberg, W. Neumann, J. Nitsch, P. Rüffer, H. Schüddekopf, U. Schiihlc. I. Sebastian, S. Stelzer, U. Strohmeyer, T. Tzscheetzsch, M. Wassermeyer (Germany), B. Johlander (ESTEC), M. Baessato, P. F. Brunello, S. Casotto, F. Don-, M. Lazzarin, E. Marchetti, F. Marzari, P. G. Nicolosi, F. Perón, F. Rampazzi, B. Saggin, G. Tondello, S. Verani, P. Zambolin ' (Italy), J. Lagerros, and B. Davidsson (Sweden). Peerreview

According to the future demographic trends the incidence of proximal humeral fractures and subsequent posttraumatic malunions and nonunions of the proximal humerus are expected to substantially increase.This article reviews the indications, techniques and outcomes of corrective osteotomy for the treatment of posttraumatic nounions and malunions of the proximal humerus.A selective literature search was performed and personal surgical experiences are reported.Malunions of the proximal humerus can occur after both surgical and conservative management of fractures. Due to the complex anatomy of the proximal humerus, malunions have to be systematically assessed regarding epiphyseal and metaphyseal malpositioning. Furthermore, the objective anatomical disorder has to be completely correlated with the subjective patient complaints. The associated soft tissue structures, such as the glenohumeral joint capsule and ligaments, long head of the biceps tendon, rotator cuff and muscles inserting in the metaphysis, can independently cause discomfort to the patient and need to be meticulously identified as such.A variety of corrective surgical strategies are available, which are indicated depending on the location and extent of the malunion. The depicted single-cut osteotomy technique represents an elegant therapeutic option for multidimensional deformities of the proximal humerus. Nonunions of the proximal humerus can usually be successfully managed with autologous cancellous bone grafting and locking plate osteosynthesis.

The management of glenohumeral osteoarthritis in younger patients with high activity levels remains a challenge to orthopedic surgeons. The clinical results of joint replacement surgery are commonly unsatisfactory in this particular cohort with the associated problem of limited longevity of the implant.This paper reviews the indications, techniques and outcomes of joint-preserving arthroscopic surgery for the treatment of osteoarthritis of the shoulder.A selective literature search was performed and personal surgical experiences are reported.Besides significant pain reduction, improved range of motion and increased patient satisfaction, arthroscopic surgery can delay the need for total shoulder arthroplasty. A comprehensive approach that addresses all concomitant pathologies of the shoulder joint is of particular importance. Recent studies have shown that a glenohumeral joint space of less than 2 mm predicts significantly poorer results with arthroscopic therapy.Arthroscopic procedures are a good option to treat young, active patients with osteoarthritis of the shoulder. Patient selection and setting a consensus for appropriate preoperative expectations are of particular relevance.

Recent studies have established the presence of 5-hydroxytryptamine (5-HT)(2A) receptors on glial cells in culture and in the brain in situ. Here we used cultured C6 glioma cells to investigate the possibility that 5-HT(2A) receptors on glia regulate glutamate release from the cell. The efflux of endogenous glutamate from cultured C6 glioma cells was increased by addition of 5-HT in a concentration-dependent manner (maximal effect +200%). The efflux of serine and aspartate was not altered. The effect of 5-HT was mimicked by both the nonselective 5-HT receptor agonist quipazine and the selective 5-HT(2) receptor agonist 4-iodo-2,5-dimethoxyamphetamine (DOI; both 0.01-100 microM). The 5-HT(2A) receptor antagonists ketanserin (1 microM) and spiperone (1 microM) inhibited the glutamate response to 5-HT, quipazine, and DOI, whereas the effect of 5-HT was not inhibited by the 5-HT(2B/C) receptor antagonist SB200646 (1 microM). The effect of 5-HT on glutamate was specific in that it was reduced in low-calcium medium but was not prevented by furosemide (5 mM), which prevents cell swelling-induced glutamate release. Finally, the glutamate uptake inhibitor 2,4,trans-pyrollidine dicarboxylic acid (50 microM) did not block the 5-HT-induced efflux of glutamate, making involvement of glutamate transport unlikely. In conclusion, 5-HT stimulates the efflux of glutamate from C6 glioma cells following 5-HT(2A) receptor activation and involves a calcium-dependent mechanism.

It has recently been suggested that an increase in brain-derived neurotrophic factor (BDNF) expression may mediate some of the therapeutic effect of antidepressant drugs, via their effects on the neurotransmitter 5-hydroxytryptamine (5-HT). However, because it is unclear whether 5-HT manipulations directly affect BDNF expression, we examined BDNF mRNA levels in C6 glioma cells following incubation with 5-HT using reverse transcription polymerase chain reaction (RT-PCR) and Northern blot analysis. Incubation of C6 glioma cells with 5-HT increased the BDNF mRNA expression approx twofold. The effect of 5-HT (100 microM) was inhibited by a 5-HT2A receptor antagonist (ketanserin; 1 microM). The RNA synthesis inhibitor (actinomycin D; 10 microg/mL), but not a protein synthesis inhibitor (cycloheximide; 0.5 microg/mL) blocked the effect of 5-HT. Furthermore, incubation of C6 glioma cells with EGTA (1 mM), a protein kinase inhibitor (staurosporine; 1 microM), the Ca2+ ATPase inhibitor thapsigargin (1 microM), or a calcium/calmodulin-dependent kinase inhibitor (KN 62; 1 microM) inhibited the response to 5-HT. Our data show that 5-HT increases de novo BDNF mRNA synthesis following direct activation of the 5-HT2A receptor, via a calcium-dependent and protein kinase-dependent pathway.

S. K. Solanki et. al., ©2017 The American Astronomical Society. All rights reserved.The Sunrise balloon-borne solar observatory, consisting of a 1 m aperture telescope that provides a stabilized image to a UV filter imager and an imaging vector polarimeter, carried out its second science flight in 2013 June. It provided observations of parts of active regions at high spatial resolution, including the first high-resolution images in the Mg ii k line. The obtained data are of very high quality, with the best UV images reaching the diffraction limit of the telescope at 3000 Å after Multi-Frame Blind Deconvolution reconstruction accounting for phase-diversity information. Here a brief update is given of the instruments and the data reduction techniques, which includes an inversion of the polarimetric data. Mainly those aspects that evolved compared with the first flight are described. A tabular overview of the observations is given. In addition, an example time series of a part of the emerging active region NOAA AR 11768 observed relatively close to disk center is described and discussed in some detail. The observations cover the pores in the trailing polarity of the active region, as well as the polarity inversion line where flux emergence was ongoing and a small flare-like brightening occurred in the course of the time series. The pores are found to contain magnetic field strengths ranging up to 2500 G, and while large pores are clearly darker and cooler than the quiet Sun in all layers of the photosphere, the temperature and brightness of small pores approach or even exceed those of the quiet Sun in the upper photosphere., The German contribution to Sunrise and its reflight was funded by the Max Planck Foundation, the Strategic Innovations Fund of the President of the Max Planck Society (MPG), DLR, and private donations by supporting members of the Max Planck Society, which is gratefully acknowledged. The Spanish contribution was funded by the Ministerio de Economía y Competitividad under Projects ESP2013-47349-C6 and ESP2014-56169-C6, partially using European FEDER funds. The National Center for Atmospheric Research is sponsored by the National Science Foundation. The HAO contribution was partly funded through NASA grant number NNX13AE95G. This work was partly supported by the BK21 plus program through the National Research Foundation (NRF) funded by the Ministry of Education of Korea. L.G. acknowledges research funding from the State of Lower Saxony, Germany. SDO is a mission of NASA's Living With a Star (LWS) program. The SDO/HMI data were provided by the Joint Science Operation Center (JSOC). The National Solar Observatory (NSO) is operated by the Association of Universities for Research in Astronomy (AURA) Inc. under a cooperative agreement with the National Science Foundation.

The incidence of extravasation of contrast medium is reported in the literature to be between 0.2 % and 0.9 %. A rare consequence of this could be compartment syndrome of the affected limb which requires immediate treatment.We report the case of a patient who developed acute compartment syndrome of the forearm after intravenous injection of radiographic contrast medium in a radiovolar vein during a computed tomography (CT) scan for multiple trauma. The clinical symptoms with pain, loss of range of motion and sensitivity functions, measurement of compartment pressure and radiological images confirmed the diagnosis. After emergency dermatofasciotomy of the forearm the full range of motion and sensitivity functions could be restored.

Fractures of the lateral clavicle and the acromion are uncommon and represent a separate entity. Fractures of the lateral clavicle demonstrate a high rate of problems, such as non-union, malunion and functional impairment when treated nonoperatively. The aim of any treatment option is full restoration of shoulder function by achieving fracture healing without significant malpositioning. Unstable fracture patterns have to be identified and should be fixed using an appropriate technique, which include plating, K-wire fixation and arthroscopic techniques which bring the dislocated fragments into contact. Dislocated fractures of the acromion can usually be treated by plating.

We present a literature review about implant removal after operative extremity and spine fracture treatment. The indication for implant removal procedures has become less frequent in recent years, but is still more common in Europe than for example in North America. The time required to perform a implant removal can easily exceed the planned amount. Implant removal can result in significant complications like soft tissue damage, fractures, infections, and other problems. Not only because of these problems, the decision on whether or not to remove the implant should be made with great care. Therefore good communication with the patient and thorough information about risks and benefits are essential.

Press-fit fixation of a tendon graft has been advocated in order to achieve tendon to bone healing.Fixation of a tendon graft with a porous bone scaffold limits bone tunnel enlargement compared with a biodegradable interference screw fixation.Between 2005 and 2006, 20 patients (17 men, 3 women) were enrolled in this study for primary reconstruction of the ACL. Patients were randomized to either obtain graft fixation in the tibial tunnel by means of an interference screw (I) or a press-fit fixation with a porous bone cylinder (P). Three months after surgery, a CT scan of the knee was performed and tunnel enlargement was analysed in the coronal and sagittal planes for the proximal, middle and distal thirds of the tunnel. After 6 months, 1 and 2 years, International Knee Documentation Committee (IKDC), Tegner and Lysholm scores of both groups were compared.The bone tunnel enlargement was 106.9±10.9% for group P and 121.9±9.0% for group I (P0.02) in the AP plane and 102.8±15.2% vs 121.5±10.1% in the coronal plane (P0.01). IKDC, Tegner, and Lysholm scores improved in both groups from pre- to postoperative assessment without significant differences between the two groups. There was a trend to higher knee stability in group P after 3 months (0.6±1.4 mm vs 1.81±.5 mm, P=0.08).Both interference screw and a press-fit fixation lead to a high number of good or very good outcomes after ACL reconstruction. Tibial press-fit fixation decreases the amount of proximal bone tunnel enlargement. Press-fit fixation decreases the amount of proximal bone tunnel enlargement and improves bone to tendon contact.

This paper describes the wave-front correction system developed for the Sunrise balloon telescope, and provides information about its in-flight performance. For the correction of low-order aberrations, a Correlating Wave-Front Sensor (CWS) was used. It consisted of a six-element Shack-Hartmann wave-front sensor (WFS), a fast tip-tilt mirror for the compensation of image motion, and an active telescope secondary mirror for focus correction. The CWS delivered a stabilized image with a precision of 0.04 arcsec (rms), whenever the coarse pointing was better than 90 arcsec peak-to-peak. The automatic focus adjustment maintained a focus stability of 0.01 waves in the focal plane of the CWS. During the 5.5 day flight, good image quality and stability was achieved during 33 hours, containing 45 sequences that lasted between 10 and 45 minutes.

The first science flight of the balloon-borne \Sunrise telescope took place in June 2009 from ESRANGE (near Kiruna/Sweden) to Somerset Island in northern Canada. We describe the scientific aims and mission concept of the project and give an overview and a description of the various hardware components: the 1-m main telescope with its postfocus science instruments (the UV filter imager SuFI and the imaging vector magnetograph IMaX) and support instruments (image stabilizing and light distribution system ISLiD and correlating wavefront sensor CWS), the optomechanical support structure and the instrument mounting concept, the gondola structure and the power, pointing, and telemetry systems, and the general electronics architecture. We also explain the optimization of the structural and thermal design of the complete payload. The preparations for the science flight are described, including AIV and ground calibration of the instruments. The course of events during the science flight is outlined, up to the recovery activities. Finally, the in-flight performance of the instrumentation is briefly summarized., Comment: 35 pages, 17 figures

The Imaging Magnetograph eXperiment (IMaX) is a spectropolarimeter built by four institutions in Spain that flew on board the Sunrise balloon-borne telesocope in June 2009 for almost six days over the Arctic Circle. As a polarimeter IMaX uses fast polarization modulation (based on the use of two liquid crystal retarders), real-time image accumulation, and dual beam polarimetry to reach polarization sensitivities of 0.1%. As a spectrograph, the instrument uses a LiNbO3 etalon in double pass and a narrow band pre-filter to achieve a spectral resolution of 85 mAA. IMaX uses the high Zeeman sensitive line of Fe I at 5250.2 AA and observes all four Stokes parameters at various points inside the spectral line. This allows vector magnetograms, Dopplergrams, and intensity frames to be produced that, after reconstruction, reach spatial resolutions in the 0.15-0.18 arcsec range over a 50x50 arcsec FOV. Time cadences vary between ten and 33 seconds, although the shortest one only includes longitudinal polarimetry. The spectral line is sampled in various ways depending on the applied observing mode, from just two points inside the line to 11 of them. All observing modes include one extra wavelength point in the nearby continuum. Gauss equivalent sensitivities are four Gauss for longitudinal fields and 80 Gauss for transverse fields per wavelength sample. The LOS velocities are estimated with statistical errors of the order of 5-40 m/s. The design, calibration and integration phases of the instrument, together with the implemented data reduction scheme are described in some detail., Comment: 17 figures

Bordetella pertussis produces a calmodulin-activated adenylate cyclase (AC) that exists in several forms. Only one form of AC, of apparent 200 kDa, is a toxin that penetrates eukaryotic cells and generates uncontrolled levels of intracellular cAMP. Recombination studies in transposon Tn5-insertion mutants of B. pertussis and amino acid sequence homology with alpha-hemolysin of Escherichia coli suggested that AC toxin may also have a hemolytic activity. Here, we demonstrate that only the toxic form of B. pertussis AC possesses hemolytic activity. Immunoblotting of membranes from sheep erythrocytes throughout the process of cell lysis detects the presence and accumulation of only the 200-kDa form of B. pertussis AC. cAMP generation induced by AC toxin in sheep erythrocytes is immediate whereas appearance of hemolysis is delayed by about 1 h and requires a higher level of AC toxin activity. Addition of exogenous calmodulin to sheep erythrocyte incubation medium potentiates the hemolytic activity of AC toxin but blocks cAMP generation. Extracellular Ca2+ at mM concentrations is absolutely required for cAMP generation but not for hemolysis. However, binding of AC toxin to sheep erythrocytes in the absence of exogenous Ca2+ followed by reincubation of cells in a toxin-free buffer containing Ca2+ leads to an immediate rise in intracellular cAMP. Human erythrocytes bind AC toxin and generate cAMP but are resistant to lysis. These results show that binding of AC toxin to erythrocytes can cause both cAMP generation and hemolysis or only one of these depending on conditions applied and cell type used.

Melorheostosis is a rare, benign, and sporadically occurring osteosclerosis of unknown cause. The onset of the disease is usually in early adulthood. Melorheostosis affects both genders, develops progressively, and is usually limited to one side of the human body. The sclerosis originates predominantly from the cortices of the long bones of the lower limbs and rarely the upper limbs. Frequently, the sclerosis involves the soft tissue surrounding the affected bones which may cause limitations in the range of motion, contractures, deformities, and pain. Melorheostosis is usually diagnosed by radiograms. Pain relief and restoration of the full range of motion are the primary goals of the therapeutic approach. A good outcome cannot always be achieved and a recurrence of the disease happens very often.

Analysis of the results and presentation of a treatment concept of a helicopter emergency medical service (HEMS) in prehospital acute care of entrapped motorists.Consecutive patient data collection from primary rescue missions of a helicopter emergency medical service (HEMS) from the years 2000-2004. Evaluation based on data collected regarding emergency medical care, rescue techniques, and tactical rescue approach.A total of 359 cases of entrapped motorists were documented: 237 patients were male, 122 were female, and the average age was 37 (range: 2-82 years). The motor vehicle accidents (MVA) occurred in 21% of the cases on the highway, in 29% on a main road, in 43% on a rural road, and in 7% in city/urban areas. Concerning the vehicle types, 86% were automobiles, 5% vans, and 9% trucks. Drivers accounted for 86% of the patients, front seat passengers for 10.1%, and back seat passengers for 3.9%. The average length of motorist entrapment amounted to 17 min with an average on-scene time of 27 min for the HEMS. The total rescue time averaged 56 min. A Glasgow Coma Scale (GCS) score between 3 and 8 was recorded in 33.7% of the patients; in 24% of the cases the shock index was1; a respiratory rate of10/min or20/min was documented in 25.2% of the patients. An NACA score between I and III was recorded in 34.2% of the cases, NACA IV in 18.9%, and NACA/=V in 46.8%; 11.9% of the patients died before hospital admission.For both the emergency control center personnel and the emergency medical technicians (EMT), a case of motorist entrapment must be considered as a trigger mechanism of injury, activating a sophisticated and time-sensitive prehospital acute care and transportation service. In the German emergency medical service this involves primarily the HEMS. Even in cases of potentially critically injured entrapped motorists, the prehospital adherence to"the golden hour of shock" is made possible, despite the resulting higher personnel and equipment expenses.

An accurate tool for a combined pre-, intra-, and postoperative stability measurment for rotation and translation after ACL reconstruction of the tibia is still not in clinical use, although these measurments provide important stability parameters. Navigation has been introduced a few years ago for the evaluation of impingement problems or the drill canal for ACL replacement but the measurement of the tibial translation and rotation is only available for a short time and only available with a few navigation modules. The navigated accuracy is 1 mm/o. In this study navigated measurement of tibial rotation and translation were evaluated with a new developed mechanical device and directly compared with a c-arm based navigation modul.

A modified surgical technique using suspension arthroplasty against primary osteoarthritis of the thumb carpometacarpal joint was analysed.This retrospective analysis focused on 41 patients who underwent suspension arthroplasties with a modified technique between 1997-2005. With the help of this technique, a long-range preparation of the flexor carpi radialis tendon can be avoided. Only the ca. 3 cm of tendon which is visible in the site was split in half and cut off proximally. This half tendon was provided with a suture in baseball-stitch technique. It was then press-fit fixed with a suture in a sloping drill hole of the MC 1 basis. The patients required a cast for only 3 weeks postoperatively. Afterwards, they received an orthesis for 2-3 weeks with increasing mobilisation. The postoperative course was clinically and radiologically analysed. The results were analysed at 3 months and 1-7 years after surgery. All patients were operated as outpatients.Of the 41 patients, 40 had a high subjective satisfaction. A total of 45 operations showed excellent results. There were no poor results. Only one patient would not undergo the surgery again. The radiological distance between metacarpal 1 and the distal scaphoid lay between 4 mm and 9 mm after 3 months and 1-7 years.The described modification of suspension arthroplasty with a short-range mobilisation of the flexor carpi radialis tendon reduced the morbidity of preparation and led to stable suspension. Thus, immobilisation over 3 weeks was not necessary. Patients obtained good, early functional results.

Vascular compression of the Vth cranial nerve is the leading cause of trigeminal neuralgia. Microvascular decompression has been promoted by Jannetta since 1970. We used the minimally invasive retrosigmoid approach, with the complementary help of endoscopic procedure.MRI results, surgical findings and pain relief were studied after endoscopic assisted microvascular decompression.Between 1991 and 2000, 98 surgeries were performed on 79 patients unresponsive to medical treatment, after an average of 6 years from the onset of the disorder. The mean follow-up period after operation was 28 months.MRI predicted neurovascular conflict with sensitivity of 93.6% and specificity of 100%. Pain relief after surgery was complete in 69% of the cases, partial in 21%. Surgery was a failure in 6% of the cases and 4% of patients were lost. Complications were limited to 10% of CSF disorders but only 1% (1 patient) needed a surgical revision.Microvascular decompression, performed through a key-hole approach, without cerebellum retraction and with endoscopic assisted surgery, yields a low risk of morbidity, even in elderly patients, and could be considered acceptable causal treatment of trigeminal neuralgia.

The operation of CESR as an electron-positron collider using trains of bunches requires, the use of beam stabilizing feedback systems at routine operating currents. These systems operate on the longitudinal and both transverse modes of dipole oscillation. The experience in routine operations and feedback system performance will be presented.

In CESR, 9 trains of 4 or 5 bunches of electrons and positrons collide at the interaction point, but bypass each other in the arcs of the storage ring using electrostatically separated orbits (pretzels). The parasitic bunch crossings resulting from the use of pretzel separation causes the bunches to have different orbits and, thus, the luminosity to be sensitive to the relative transverse positions of colliding bunches. We measure the bunch-by-bunch position projected to the interaction point from information available from the transverse feedback systems used for beam stabilisation. Some modification of the feedback systems has permitted the application of a bunch-by-bunch deflection designed to adjust the relative positions of colliding bunches. Observation of bunch-by-bunch position during collisions and the effect of relative position adjustments will be presented.

We recently reported that 5-hydroxytryptamine(2A) (5-HT(2A)) receptor activation on cultured glial cells induces glutamate release [J. Neurosci. Res. 67 (2002) 399]. Here we use C6 glioma cells to examine the role of calcium in this response. 5-Hydroxytryptamine (5-HT) increases glutamate release from C6 glioma cells, an effect blocked by low calcium conditions. The calcium ionophores ionomycin and calcimycin also released glutamate from C6 glioma cells in a Ca(2+)-dependent manner. The effect of 5-HT was reduced by the phospholipase C inhibitor U73122 (1-[6[[(17 beta)-3-methoxyestra-1,3,5(10)-trien-17-yl]amino]hexyl]-1H-pyrrole-2,5-dione), but not its inactive enantomer U73343(1-[6[[(17 beta)-3-methoxyestra-1,3,5(10)-trien-17-yl]amino]hexyl]-2,5-pyrrolidinedione). The protein kinase C inhibitors staurosporine and calphostin C had no effect on the response to 5-HT, whereas the response was blocked by thapsigargin and caffeine. Neither the L-type calcium channel blockers, nifedipine and verapamil, nor the N-type calcium channel blocker omega-conotoxin GVIA inhibited the effect of 5-HT, whereas NiCl(2) and KCl blocked the response to 5-HT. We conclude that the 5-HT-induced efflux of glutamate from C6 glioma cells is Ca(2+)-dependent and involves, at least in part, the mobilisation of Ca(2+) from inositol (1,4,5) tris phosphate (IP(3)) sensitive intracellular stores.