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Speicheldrusentumoren sind zwar sehr selten, zeigen aber eine grose morphologische Heterogenitat mit uber 30 verschiedenen Entitaten. In jungster Zeit liesen sich die verschiedenen Tumoren nicht nur histologisch und immunhistochemisch, sondern auch molekular besser als zuvor charakterisieren, sodass zunehmend sog. Treibermutationen, die eine Rolle bei der Entwicklung neuer, auf eine Zielstruktur gerichteter Therapien spielen, entdeckt wurden. Ziel des Beitrags ist es, grundlegende morphologische und immunhistochemische Parameter zur Differenzierung einzelner Tumorentitaten vorzustellen sowie einen Uberblick uber die bislang gefundenen genetischen Aberrationen der haufigsten Speicheldrusentumoren zu geben. Falle aus dem eigenen Einsendegut mit histochemischen Standard- und immunhistochemischen Sonderfarbungen werden prasentiert. Daneben bildet eine umfassende Literaturrecherche den derzeitigen Kenntnisstand uber molekulare Veranderungen in Speicheldrusentumoren ab. In der histopathologischen Diagnostik differenzierter Speicheldrusentumoren ist die immunhistochemische Markierung basaler/myoepithelialer und luminaler/epithelialer Zellen zur Beurteilung von Komposition und Architektur verschiedener Zelltypen neben der Bestimmung der proliferativen Aktivitat essenziell. Auf Basis einer korrekten Tumortypisierung konnen verschiedene molekulare Parameter untersucht werden, um im Falle hoch differenzierter nichtmetastasierter Tumoren die Diagnose weiter zu verifizieren und im Falle gering differenzierter, metastasierter Tumoren mogliche therapeutische Zielstrukturen zu identifizieren. Bei hochaggressiven Karzinomen erscheint nach heutigem Kenntnisstand die Erstellung eines umfassenden genomischen Profils wesentlich.

The occupation of the Niels Bohr Institute by German authorities in war-time Denmark has hitherto not been described or analyzed in detail, leaving a number of questions open, such as the background and purpose of the occupation, the lack of planning of the operation, formation, mandate and actual work of the “Expert Commission,” and the justification of release without conditions. These questions are addressed and answers suggested compatible with all relevant facts available.

Carbon fibers composites are well-known as high tech materials but are also recognized as a problem after use as they have to be deposited in landfills. Pyrolysis is an attractive process for recycling carbon fibers from used composites as well as offcuts from prepregs. Pyrolysis of carbon fiber composite prepregs is carried out in a pilot plant with a single screw reactor. The pyrolysis products, carbon fibers and pyrolysis vapor are fully characterized. Variation of pyrolysis temperature is carried out to obtain carbon fibers with the best possible surface properties. In order to compare the mechanical properties of the recycled carbon fibers with virgin material, composite materials with polyamide are produced and their properties compared.

Asphyxia of newborns is a severe and frequent challenge of the peri- and postnatal period. Forty-four neonatal piglets underwent asphyxia and hemorrhage (AH), followed by resuscitation with blood or crystalloid transfusion. In this study, 15 piglets (blood n = 9, NaCl n = 6, mean age 31 h) were randomly chosen. Four hours after return of spontaneous circulation, heart tissue and blood were collected. Analyses of heart fatty acid binding protein (HFABP), cardiac troponin I (TnI) levels, and activation of the complement system were performed. Histological staining for connexin 43 (Cx43) and complement C5a receptor 1 (C5aR1) was performed. Following AH, systemic elevation of cardiac TnI and HFABP revealed cardiac damage in both groups. Systemic activation of the complement system and the appearance of extracellular histones in plasma of the blood transfusion group were observed. The Cx43 was translocated from the intercalated discs to the cytosol after AH. Cardiac glycogen concentration was reduced in both groups. A significant reduction of C5aR1 in the left ventricle and a significant elevation of the heart injury score were investigated after blood transfusion. AH leads to alteration of the heart, particularly in Cx43 and glycogen reserves, as well as local inflammation.

Material models exhibiting softening effects due to damage or localization share the problem of leading to ill-posed boundary value problems that lead to physically meaningless, mesh-dependent finite element results. It is thus necessary to apply regularization techniques that couple local behavior, described, e.g., by internal variables, at a spatial level. The common way to do this is to take into account higher gradients of the field variables, thus introducing an internal length scale. In this paper, we suggest a different approach to regularization that does not make use of any nonlocal enhancement like the inclusion of higher gradients or integration over local sub-domains nor of any classical viscous effects. Instead we perform an appropriate relaxation of the (condensed) free energy in a time-incremental setting which leads to a modified energy that is coercive and satisfies quasiconvexity in an approximate way. Thus, in every time increment a regular boundary value problem is solved. The proposed approach holds the same advantage as other methods, but with less numerical effort. We start with the theoretical derivation, discuss a rate-independent version of the proposed model and present details of the numerical treatment. Finally, we give finite element results that demonstrate the efficiency of this new approach.

To develop and evaluate methods for assembling radiopaque printed paper sheets to realistic patient phantoms for CT dose and image quality testing. CT images of two patients were radiopaque printed with aqueous potassium iodide solution (0.6 g/ml) on paper. Two methods were developed for assembling the paper sheets to head and neck phantoms. (1) Printed sheets were fed to a paper-based 3D printer along with corresponding 3D printable STL files. (2) Paper stacks of 5-mm thickness were glued with toner, cut to the patient shape and assembled to a phantom. In a sample application study, both phantoms were examined with five different tube current settings. Images were reconstructed using filtered-back projection (FBP) and iterative reconstruction (AIDR 3D) with three strength levels. Dose length product (DLP), signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNRs) were analysed. Data were analysed using 2-way analysis of variance (ANOVA). Both methods achieved anthropomorphic phantoms with detailed patient anatomy. The 3D printer yielded a precise reproduction of the external patient shape, but caused visible glue artefacts. Gluing with toner avoided these artefacts and yielded more flexibility with regard to phantom size. In the sample application study, non-inferior SNR and CNR and up to 83.7% lower DLP were achieved on the phantoms with AIDR 3D compared with FBP. Two methods for assembling radiopaque printed paper sheets to phantoms of individual patients are presented. The sample application demonstrates potential for simulation of patient imaging and systematic CT dose and image quality assessment. • Two methods were developed to create realistic CT phantoms of individual patients from radiopaque printed paper sheets. • Analysis of five tube current and four reconstruction settings on two radiopaque 3D printed patient phantoms yielded non-inferior SNR and CNR and up to 83.7% lower dose with iterative reconstruction in comparison with filtered back projection. • Radiopaque 3D printed phantoms can simulate patients and allow systematic analysis of CT dose and image quality parameters.

Objective To compare prostate volume and prostate-specific antigen (PSA) levels with bacterial growth in prostate tissue cultures. Materials and Methods Fifty male patients who underwent transurethral prostate resection were investigated prospectively. Resection chips from the prostate gland were added to brain-heart infusion medium and incubated. PSA levels were determined preoperatively at our urology ward. The prostate gland volume was estimated by transabdominal ultrasound examination preoperatively. Results Persons with positive bacterial prostate tissue cultures have a greater prostate volume. This is significant in patients with and without histopathologic signs of prostatitis. Persons with positive bacterial prostate tissue cultures have higher PSA values. This is significant in patients without histopathologic signs of prostatitis. Conclusion People with positive bacterial prostatic tissue culture have a higher prostate volume in comparison with patients with negative culture findings and show a tendency toward increased PSA levels as well.

The following article explores the interdependency between urban crisis as a pre-condition for self-organised responses to it and self-organised projects that try to provide solutions for problems caused by the respective crisis. Berlin is taken as specific field of investigation as self-organisation is very much linked to its recent history and it therefore seems to be a very relevant case for this topic. The example of the International Building Exhibition 1984/1987 in Berlin (IBA 84/87) is studied as a historic reference to provide a framework for comparing more recent processes with a long-term experience since the late 1980’. Four recent examples of self-organised projects that aim to provide spaces without profit are presented with the focus on their creation processes. The article further explores the specific relationship between Berlins’ actual housing crisis and various forms of self-organised reactions to it. Finally, the research tries to explore possible impacts these projects might have on formal local planning structures in a long-term perspective.

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous diagnostic category with clinical manifestations in virtually every location. Here, we investigated the frequencies of mutations affecting C...

Die Restauration sieht man gemeinhin als eine Epoche der Rückbesinnung auf die vorrevolutionäre Zeit; die von Napoleon gestürzten Monarchen kehrten zurück und die Macht der Fürsten wurde wiederhergestellt bzw. durch die «Heilige Allianz» sogar noch zementiert. Doch was bedeutet diese Epoche für die Schweiz, die seit Jahrhunderten keinen privilegierten Hochadel kannte? War die «Restauration» für die Schweiz eine Phase der Wiederherstellung alter Verhältnisse oder vollzog sich schon jetzt in wesentlichen Belangen ein gesellschaftspolitischer Wandel? Diesen Fragen widmet sich der Autor, der in seiner Untersuchung auch die Biographien über namhafte Politiker einbezieht. Er zeigt, dass die Restauration nicht Stillstand bedeutete, sondern dass Kontinuitäten und die Emanzipation hinsichtlich einer zunehmenden Unabhängigkeit vom Einflussbereich des Auslandes sie prägten.

Introduction: General anaesthesia (GA) during mechanical thrombectomy (MT) might lead to an inferior clinical outcome compared to conscious sedation (CS). It was hypothesised that using CS might avoid a critical drop in cerebral perfusion, shorten the time of the intervention and therefore might result in better clinical outcome. In this study, we compared the procedural and clinical results of patients who underwent MT under GA or CS at two tertiary neuro-vascular centres on the basis of a matched-pair analysis. Methods: Using a matched-pair approach, we compared the data of 56 patients that were treated under CS at centre A (n = 28) with selected patients who were treated under GA at the centre B (n = 28). Patients were matched for age, sex, site of vessel occlusion, NIHSS at admission (±3 points), time from symptom onset to initial stroke imaging, intravenous-lysis and co-morbidities. All patients had an ASPECT-score of ≥8. To exclude the effect of technical failures, only patients with successful recanalization of the occluded vessel (TICI 2b and 3) were included into the study. The primary endpoint was the proportion of patients with early good clinical outcome after MT, defined by a modified Ranking Scale (mRS)-score ≤2 at discharge. Secondary endpoints were the time from symptom onset to the start of the procedure, the duration of the procedure and the rate of procedural complications. Results: There were no differences concerning gender, age, the site of vessel occlusion and the degree of stroke severity at baseline. The proportion of patients with an early good clinical outcome (mRS ≤2 at discharge) was 60.4% (17/28) in both groups. The time from symptom onset to the start of the procedure was shorter at centre B, while the duration of the procedure was significantly faster at A, resulting in an overall time from symptom onset to complete recanalization of 152.2 ± 68.0 min for patients treated at centre A and 171.1 ± 43.5 min for patients at centre B (ns). Conclusion: Our study revealed no differences in the investigated clinical outcome for patients undergoing endovascular stroke treatment under GA versus CS.

Material models, including softening effects due to, for example, damage and localizations, share the problem of ill-posed boundary value problems that yield mesh-dependent finite element results. It is thus necessary to apply regularization techniques that couple local behavior described, for example, by internal variables, at a spatial level. This can take account of the gradient of the internal variable to yield mesh-independent finite element results. In this paper, we present a new approach to damage modeling that does not use common field functions, inclusion of gradients or complex integration techniques: Appropriate modifications of the relaxed (condensed) energy hold the same advantage as other methods, but with much less numerical effort. We start with the theoretical derivation and then discuss the numerical treatment. Finally, we present finite element results that prove empirically how the new approach works.

The incidence of cardiac injury in immediate fatalities after blunt trauma remains underestimated, and reliable diagnostic strategies are still missing. Furthermore, clinical data concerning heart-specific troponin serum levels, injury severity score (ISS), catecholamine treatment and survival of patients on admission to the hospital have rarely been interrelated so far. Therefore, the object of the present study was to identify predictive parameters for mortality in the context of blunt cardiac injury. This retrospective observational study included 173 severely injured patients with an ISS ≥25 admitted to the University Hospital of Ulm, a level 1 trauma center, during 2009–2013 . Furthermore, 83 blunt trauma victims who died before hospital admission were subjected to postmortem examination at the Institute of Legal Medicine, University of Ulm, during 2009–2014. ISS, cardiac injury and associated thoracic injuries were determined in both groups. Furthermore, in the hospitalized patients, serum troponin and IL-6 levels were measured. Macroscopic heart injury was observed in 18 % of the patients who died at the scene and only in 1 % of the patients admitted to the hospital, indicating that macroscopic heart injury is associated with an immediate life-threatening condition. Troponin levels were elevated in 43 % of the patients after admission to the hospital. Moreover, troponin serum concentrations were significantly higher in patients treated with norepinephrine (26.4 ± 4 ng/l) and in non-survivors (84.9 ± 22.8 ng/l) compared to patients without catecholamines and survivors, respectively. Macroscopic heart injury was 20 times more frequent in non-survivors than in survivors. Serum troponin levels correlated with mortality after multiple injury and therefore may represent a valuable prognostic marker in trauma patients.

Im Rahmen der Schädigungsmodellierung führen charakteristische Entfestigungs- und Lokalisierungseffekte zu schlecht gestellten Randwertproblemen. Folglich treten numerische Instabilitäten und netzabhängige Finite-Elemente-Ergebnisse auf. Um die genannten Probleme zu lösen, werden Regularisierungsstrategien angewendet, welche normalerweise mit einem hohen numerischen Aufwand einhergehen. Gegenstand dieser Arbeit ist die Entwicklung neuartiger Ansätze, welche Schädigungsmodelle effizienter regularisieren. Es werden drei neuartige Ansätze vorgestellt: Das erste Modell basiert auf Energierelaxierung zusammen mit einer nicht linearen Homogenisierung zweier Phasen. Das zweite Modell verwendet eine Ratenlimitierung im Zusammenhang mit einem emulierten repräsentativen Volumenelement. Das dritte Modell hat eine Gradienten-erweiterte Formulierung und wertet den Laplace Operator effizient aus. Die unterschiedlichen neuartigen Modelle werden einander gegenübergestellt und bewertet., In the context of damage modeling, characteristic softening and localization effects lead to ill-posed boundary value problems. Consequently, numerical instabilities and mesh-dependent finite element results occur. In order to solve the aforementioned problems, regularization strategies are applied, which are usually accompanied by a high numerical effort. Subject of this work is the development of novel approaches that regularize damage models more efficiently. Three novel approaches are introduced: the first model is based on energy relaxation along with a non-linear homogenization of two phases. The second model uses rate limitation in connection with an emulated representative volume element. The third model has a gradient-enhanced formulation and efficiently evaluates the Laplace operator. The different novel models are contrasted with each other and assessed., Mitteilungen aus dem Institut für Mechanik, 182

ObjectiveAsphyxia of newborns is a severe and frequent challenge of the peri- and postnatal period. The purpose of this study was to study early morphological, immunological and structural alterations in lung tissue after asphyxia and hemorrhage (AH).Methods44 neonatal piglets (age 32 hrs) underwent asphyxia and hemorrhage (AH) and were treated according to the international liaison committee of resuscitation (ILCOR) guidelines. For this study, 15 piglets (blood transfusion (RBC) n = 9; NaCl n = 6, mean age 31 hrs) were randomly picked. 4 hours after ROSC (return of spontaneous circulation), lung tissue and blood samples were collected.ResultsAn elevation of myeloperoxidase (MPO) activity was observed 4 hrs after AH accompanied by an increase of surfactant D after RBC treatment. After AH tight junction proteins Claudin 18 and junctional adhesion molecule 1 (JAM1) were down-regulated, whereas Occludin was increased. Furthermore, after AH and RBC treatment dephosphorylated active form of Connexin 43 was increased.ConclusionsAH in neonatal pigs is associated with early lung injury, inflammation and alterations of tight junctions (Claudin, Occludin, JAM-1) and gap junctions (Connexin 43) in lung tissue, which contributes to the development of lung edema and impaired function.

As damage occurs in the context of high stresses that are also related to the presence of plastic strains, it is natural to investigate the effect of plasticity on damage evolution and to thus achieve a more realistic model. In this work, the existing and new damage model presented in [Junker P, Schwarz S, Makowski J, Hackl K. Continuum Mech. Therm. 2017, 29 (1), 291–310] is enhanced with plasticity and isotropic hardening. The damage model is based on a relaxation-based approach and does not require additional complex regularization techniques besides considering viscous effects. The benefit of the model are mesh-independent results for the rate-dependent case, even without considering, e.g. gradient terms for mathematical regularization. The enhancement with plasticity and isotropic hardening was investigated for a representative volume element that considerd a damaging matrix material and non-damaging hard precipitates. Two different loading types, pure tension and pure shear, yielded the homogenized stress/strain response for the material at various loading rates. Hereto, several finite discretizations in terms of finite-element meshes were used. The results underline the mesh-independence for physically reasonable loading rates and viscosities.

Gut vernetzt gut verwaltet. Wer mit Fragen der strategischen Steuerung, des Datenschutzes und des Verwaltungshandelns vor dem Hintergrund der Digitalisierung befasst ist, findet in diesem Band topaktuelle Antworten. Auf dem neuesten Rechtsstand – inkl. DSGVO und der Erklärung von Tallinn. Integrativ und ebenenübergreifend werden gleichermaßen die EU-, Bundes-, Landes- und Kommunalebene behandelt. Gut lesbar eignet sich der Band als Einstiegslektüre und zur Vertiefung. Mit einem Geleitwort der Staatsministerin für Digitalisierung, Dorothee Bär.

Objective: To describe a method to retrieve cellular and tissue elements of oral squamous epithelium obtained by abrasive methods and to conduct investigations by cytohistology. Method: We developed a special gelatine pocket suitable for paraffin embedding of sparse material obtained from brush biopsies (BBs). This was subjected to combined evaluation of a cytological (smear) and histological examination of the ‘tissue sections’ – referred as cytohistology. Four diagnostic categories were applied for evaluation. Other special diagnostic methods were also applied in addition to recording dysplasia. Results: A total of 51, 755 BBs from suspicious lesions of the oral mucosa (mostly oral potentially malignant disorders – OPMD) were evaluated for the presence of carcinoma or dysplasia; in all, 1.7% were positive, 78.2% were negative for any epithelial atypia, 16.8% atypical and 3.3% inadequate. All BBs also had cytohistological evaluation. A ‘positive’ diagnosis by cytohistology was a reliable indicator of dysplasia or carcinoma, requiring further incisional/excisional biopsy. In the ‘atypical’ category, a variety of lesions were found, about half being dysplasia or carcinoma. This category challenges the clinician for further clinical, therapeutic and/or excisional examination. In ‘negative’ cases with persistence of the lesion, a re-examination in 1-year sequence is recommended. Conclusion: Cytohistology of material derived by abrasive methods allows earlier detection of dysplasia/carcinoma. A number of additional oncological and non-oncological findings make this method a valuable non-invasive diagnostic procedure for oral mucosal lesions.

Background: Evidence for recommendations on the use of volume expansion during cardiopulmonary resuscitation in newborn infants is limited. Objectives: To develop a newborn piglet model with asphyxia, hemorrhage, and cardiac arrest to test different volume resuscitation on return of spontaneous circulation (ROSC). We hypothesized that immediate red cell transfusion reduces time to ROSC as compared to the use of an isotonic crystalloid fluid. Methods: Forty-four anaesthetized and intubated newborn piglets [age 32 h (12–44 h), weight 1,220 g (1,060–1,495g), Median (IQR)] were exposed to hypoxia and blood loss until asystole occurred. At this point they were randomized into two groups: (1) Crystalloid group: receiving isotonic sodium chloride (n = 22). (2) Early transfusion group: receiving blood transfusion (n = 22). In all other ways the piglets were resuscitated according to ILCOR 2015 guidelines [including respiratory support, chest compressions (CC) and epinephrine use]. One hour after ROSC piglets from the crystalloid group were randomized in two sub-groups: late blood transfusion and infusion of isotonic sodium chloride to investigate the effects of a late transfusion on hemodynamic parameters. Results: All animals achieved ROSC. Comparing the crystalloid to early blood transfusion group blood loss was 30.7 ml/kg (22.3–39.6 ml/kg) vs. 34.6 ml/kg (25.2–44.7 ml/kg), Median (IQR). Eleven subjects did not receive volume expansion as ROSC occurred rapidly. Thirty-three animals received volume expansion (16 vs. 17 in the crystalloid vs. early transfusion group). 14.1% vs. 10.5% of previously extracted blood volume in the crystalloid vs. early transfusion group was infused before ROSC. There was no significant difference in time to ROSC between groups [crystalloid group: 164 s (129–198 s), early transfusion group: 163 s (162–199 s), Median (IQR)] with no difference in epinephrine use. Conclusions: Early blood transfusion compared to crystalloid did not reduce time to ROSC, although our model included only a moderate degree of hemorrhage and ROSC occurred early in 11 subjects before any volume resuscitation occurred.

This paper proposes a 2/3/4/-step commutation strategy for direct three-level matrix converters (DTMC) based on input phase voltage measurement. While the DTMC is investigated since the beginning of the 21st century, the differences in the commutation to the direct matrix converter (DMC) has not been investigated in detail. The added commutation paths lead to a new set of finite state machines (FSM), which force the current flow to the neutral point potential of the filter capacitor. Concentrating on the output voltage generation, the commutation from and to the neutral point potential will be focused and the known FSM for voltage based commutation will be extended. Additionally, the usability of short-term changes in the commutation target phase, will be discussed. They become interesting when the input data of the FSM changes during a multi-step commutation. The output voltage deviation caused by the multi-step commutation will be analyzed and the functionality will be proven by experimental results.