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The present work aims to develop a wearable, textile-integrated NIRS-based tissue oxygen saturation (StO

Tissue oxygen saturation (StO

Tissue oxygen saturation (StO2) is a crucial factor in the aetiology of pressure injury (PI), since hypoxia leads to necrotization. Pressure on the tissue occludes blood circulation and reduces the StO2, resulting in hypoxia. PI causes severe suffering, heals slowly and is expensive to treat. Hence it is important to prevent PI by detecting hypoxia, e.g., by near-infrared spectroscopy (NIRS) monitoring of StO2. For this, the NIRS device has to be wearable for a long time and it is crucial that it provokes no pressure itself. An integration of optical fibres into a textile achieves this. The aim was to investigate the feasibility of such a textile NIRS device.Knots and loops were tested as textile light emitters (LEs) or detectors (LDs) on a phantom. The light coupling efficiency of the LEs and LDs was investigated.Results show that knots perform similarly to loops. More loops per fibre increase efficiency both in LEs and in LDs. The best trade-off is at 3 loops. LEs are slightly more efficient than LDs, with an average attenuation from baseline of about -2 dB for loops of 0.5 mm diameter. Adding fibres multiplies the signal by the number of fibres. Inclusions mimicking hypoxia in phantoms were successfully identified. In-vivo arm occlusion tests showed the expected decrease in StO2. This shows feasibility of optical fibres in a textile to prevent PI.

BACKGROUND: The laser Doppler fluxmetry (LDF) is a non-invasive method to assess skin blood perfusion, measuring the flow of blood cells inside a tissue volume without harming the tissue. In the diagnosis of skin circulation disorders, the results of the LDF measurement are generally used in such a way that “normal” (or non-ill) or “pathological” values are achieved by comparison with a reference sample, for example of apparently healthy subjects. MATERIAL AND METHODS: In this study, the values of LDF for the diagnosis of microcirculatory disorders in patients with coronary artery disease (n = 20) or in patients with microcirculatory disorders, already diagnosed by capillary microscopy (n = 46), were examined. RESULTS: The mean values of LD amplitudes in the four frequency windows for patients with coronary artery disease were in the reference range. However, some of the patients showed reduced LD values: in eleven of the twenty patients, one or more mean LD amplitudes were below the reference range. Four of the eleven patients had pathologically decreased capillary erythrocyte velocities of v ery = 0.09–0.21 [mm/s], while the other seven patients had normal blood circulation at rest. For all patients with a proven cutaneous microcirculatory disorder, the mean LD amplitude in at least one of the frequency windows FF2 to FF4 was pathologically reduced. CONCLUSION: The Laser-Doppler fluxmetry method used in the study allows the reliable diagnosis of cutaneous microcirculatory disorders.

Osteoarthritis (OA) of the knee is a widespread disease, often resulting in pain, restricted mobility and a reduction of activities and participation. Initial studies gave hints that Acoustic Emission Analysis (AEA) is capable of detecting early changes in cartilage structure. However, up to date no in vivo validation studies have been conducted. A prospective pilot study was conducted to investigate this diagnostic capability and the accuracy of the AEA, using magnetic resonance imaging (MRI) as a reference standard. Additionally, potential factors influencing false positive or negative results were studied. Twenty-eight patients, receiving MRI due to discomfort of the knee, were examined with AEA. Sensitivity was 0.92 for the whole knee and 0.86 to 1 for different parts of the knee. The specificity was 0.7 and 0.59 to 0.78, respectively. Confidence intervals varied between 0 and 0.33 for sensitivity and 0.1 and 0.24 for specificity. The diagnostic accuracy of the AEA was shown to be good to very good. However, because of the relatively small number of patients involved, interpretation of the data should be handled with care. Future studies with greater sample sizes have to be conducted to confirm the results of this investigation.

Zusammenfassung Hintergrund: Die Untersuchung des Bewegungsumfangs ist fester Bestandteil des Assessments bei Patienten mit Nackenschmerz. Bewegungseinschränkungen gelten als sicheres Zeichen für akute Schmerzzustände. Bei chronischem Nackenschmerz ist das Vorhandensein von Bewegungseinschränkungen jedoch fraglich. Ziel: Die vorliegende Erhebung untersuchte, ob Patienten mit chronischem Nackenschmerz Bewegungseinschränkungen aufweisen. Methode: 60 gesunde Probanden und 60 Patienten mit chronischem Nackenschmerz wurden mittels Ultraschalltopometrie während zyklischer Bewegungen der HWS bezüglich des Bewegungsumfangs untersucht und die Mittelwerte beider Gruppen auf signifikante Unterschiede überprüft. Ferner erfolgte die Klassifikation der gemessenen Bewegungsumfänge anhand geschlechts- und altersspezifischer Normwerte als normal, hypermobil oder hypomobil. Für die Validität des Befundes „hypomobil“ in Bezug auf die Erkennung des chronischen Nackenschmerzes wurden die Sensitivität, die Spezifität sowie die positive (LR+) und die negative Likelihood Ratio (LR–) ermittelt. Ergebnisse: Die durchschnittlichen Bewegungsumfänge beider Gruppen unterschieden sich in alle Richtungen signifikant. Im Vergleich zu den Normwerten wiesen mehr als drei Viertel der Teilnehmer beider Gruppen eine normale Beweglichkeit auf. Die Sensitivität des Kriteriums „Hypomobilität“ lag bei maximal 0,23, die Spezifität bei über 0,9, die LR+ bei maximal 0,93 und der niedrigste Wert der LR– bei 0,65. Schlussfolgerung: Beim chronischen Nackenschmerz ist das Bewegungsausmaß der HWS nicht vermindert. Für das Assessment fehlt ein objektiver Parameter, der mit psychosozialen Variablen korreliert und von Physiotherapeuten gemessen werden kann.

Introduction: Mutations in erb-b2 receptor tyrosine kinase 2 (HER2)oncogene are observed in approximately 3% of lung adenocarcinomas or mixed tumors with adenocarcinoma component. Activity of various biologically distinct HER2 inhibitors, including the pan-HER inhibitor afatinib, has been reported in several retrospective trials or small series in advanced pretreated NSCLC with HER2 mutations. We report the first prospective evaluation of afatinib for the treatment of this molecularly defined entity. Methods: NICHE, a single-arm phase II trial using a two-stage Simon's design, explored the potential of afatinib to control disease in pretreated patients with advanced NSCLC harboring HER2 exon 20 mutations. A total of 13 patients entered the trial and were treated with afatinib 40 mg/day until tumor progression or lack of tolerability. Results: The first-stage stopping boundary was crossed when five of nine patients did not achieve disease control at 12 weeks. The accrual into the trial was stopped with total 13 patients enrolled, with 7 (53.8%)achieving disease control at 12 weeks. Except for 1 patient with early death, progression was documented for all patients, with median progression-free survival of 15.9 weeks (95% confidence interval: 6.0–35.4), and median overall survival of 56.0 weeks (95% confidence interval: 16.3– upper limit not estimable). The toxicity profile was in the expected range. Conclusions: Afatinib did not show the expected potential for disease control in NSCLC. However, more than half of the patients in the full cohort achieved disease control at 12 weeks. © 2019 International Association for the Study of Lung Cancer

The Laser Doppler technique (Laser-Doppler-Fluxmetry, LDF), a noninvasive method to estimate skin blood flow (LDF), is frequently used in research and clinical routine [1]. Here, the measurements were carried out with a new Laser Doppler system, the DOP-system, which allows to measure frequency spectra in four different frequency windows according to the velocities in venules (low velocity), capillaries (low to medium velocities), and in arteries (with high and very high velocities). However, the diagnostic reliability or the effectiveness of the LDF has not yet been evaluated sufficiently, which is indispensable, where medical diagnostics and therapy controls are concerned. For a valid interpretation of LDF values of individual patients, the knowledge of the reference range and the variability of the measured parameters is required.In four successive studies the reference range (62 apparently healthy subjects), the circadian variability (8 subjects), the variability from day-to-day (6 subjects) and over one year with monthly measurements (6 subjects) were evaluated.With the knowledge of the reference range, microcirculatory disorders can now be diagnosed using the DOP method. Following a standard measurement procedure there was no dependence of the measured data on the day or season of measurement.

We are increasingly exposed to colored light, but its impact on human physiology is not yet extensively investigated. In the present study we aimed to determine the effects of colored light on human cerebral Mayer wave activity (MWA). We measured oxy- ([O

Haemoglobin concentration in blood is one of the most frequently measured analytes in laboratory medicine. Reference and routine methods for the determination of the haemoglobin concentration in blood are based on the conversion of haeme, haemoglobin and haemiglobin species into uniform end products. The total haemoglobin concentration in blood is measured using the absorbance of the reaction products. Traceable absorbance measurement values on the highest metrological level are a prerequisite for the calibration and evaluation of procedures with respect to their suitability for routine measurements and their potential as reference measurement procedures. For this purpose, we describe a procedure to establish traceability of spectral absorbance measurements for the haemiglobincyanide (HiCN) method and for the alkaline haematin detergent (AHD) method. The latter is characterized by a higher stability of the reaction product. In addition, the toxic hazard of cyanide, which binds to the iron ion of the haem group and thus inhibits the oxygen transport, is avoided. Traceability is established at different wavelengths by applying total least-squares analysis to derive the conventional quantity values for the absorbance from the measured values. Extrapolation and interpolation are applied to get access to the spectral regions required to characterize the Q-absorption bands of the HiCN and AHD methods, respectively. For absorbance values between 0.3 and 1.8, the contributions of absorbance measurements to the total expanded uncertainties (95% level of confidence) of absorbance measurements range from 1% to 0.4%.

Die „Empfehlung fur die Begutachtung der beruflichen Larmschwerhorigkeit“ – bisher bekannt als „Konigsteiner Merkblatt“ (jetzt: „Konigsteiner Empfehlung“) – stellt seit 1974 die Grundlage fur die Begutachtung der BK-Nr. 2301 dar. Sie wurde mehrfach aktualisiert, zuletzt im Jahr 2012, und stellt den aktuellen medizinischen Kenntnisstand zusammen. Ein neues Mas zur Larmexposition im gesamten Berufsleben wurde eingefuhrt: die Effektive Larmdosis nach Liedtke (ELD). Die otoakustischen Emissionen sind jetzt die wichtigsten Tests zum Nachweis des Haarzellschadens. Der Begleit-Tinnitus muss jetzt umfangreich untersucht werden. Die bisherige Horverlustberechnung und MdE-Einschatzung wurden beibehalten, da sich die Vorschlage bewahrt haben und keine anderen, allgemein akzeptierten Hortests bzw. Tabellenwerke existieren. Die Indika­tion zur Horgerateversorgung orientiert sich kunftig an der Hilfsmittelrichtlinie. Fur das Standardgutachten wurde das Formular uberarbeitet und die Honorierung angepasst.

PURPOSE: The purpose of this study was to investigate the presence, configuration, and progression of peripapillary atrophy (PPA) relative to macular geographic atrophy (GA) in AMD. METHODS: Confocal scanning laser ophthalmoscopy images of 413 eyes of 413 patients with GA secondary to AMD (median age, 77.0 years) were evaluated for the presence and configuration of PPA at baseline. In addition, the progression of PPA and the regression of the shortest linear dimension between PPA and GA ("buffer zone") were assessed in 164 eyes that had completed 12 months of follow-up. RESULTS: At baseline, PPA was present in 357 (86.4%) of 413 eyes, of which 330 eyes (79.9%) were classified as nonconfluent and 27 eyes (6.5%) as confluent PPA. At month 12, eight eyes had transformed from nonconfluent to confluent PPA. The median buffer zone at baseline was significantly smaller in these latter eyes than in eyes where the PPA remained nonconfluent (168.46 vs. 1451.64 μm; P < 0.001). The mean regression rate of the buffer zone was 163.0 μm/y (interquartile range, 77.2-281.3). CONCLUSIONS: Peripapillary atrophy is highly prevalent in eyes with GA due to AMD. Assessment of the buffer zone in eyes with nonconfluent PPA at baseline may be helpful to identify subjects at risk for the progression to confluent PPA. In future interventional clinical trials, it may be useful to exclude any eyes both with confluent PPA at baseline and at risk for development of confluent PPA over time to improve the accuracy of GA lesion size quantification and its enlargement over time.

Nasal spray from lemon and quince (LQNS) is used to treat hay fever symptoms and has been shown to inhibit histamine release from mast cells in vitro. Forty-three patients with grass pollen allergy (GPA) were randomized to be treated either with placebo or LQNS for one week, respectively, in a cross-over study. At baseline and after the respective treatments patients were provoked with grass pollen allergen. Outcome parameters were nasal flow measured with rhinomanometry (primary), a nasal symptom score, histamine in the nasal mucus and tolerability. In the per protocol population absolute inspiratory nasal flow 10 and 20 min after provocation was higher with LQNS compared to placebo (-37 ± 87 mL/s; p = 0.027 and -44 ± 85 mL/s; p = 0.022). The nasal symptom score showed a trend (3.3 ± 1.8 in the placebo and 2.8 ± 1.5 in the LQNS group; p = 0.070) in favor of LQNS; the histamine concentration was not significantly different between the groups. Tolerability of both, LQNS and placebo, was rated as very good. LQNS seems to have an anti-allergic effect in patients with GPA. Copyright © 2016 John WileySons, Ltd.

Hintergrund: Bei der Polyneuropathie handelt es sich um eine Schadigung mehrerer oder aller peripheren Nerven. Sie kann mit teils qualenden neuropathischen Schmerzen einhergehen und ist fur erhebliche Morbiditat, eine erhohte Mortalitat und Beeintrachtigung der Lebensqualitat verantwortlich. Durch die Polyneuropathie kommt es zudem zu haufigen Sturzen. Die Schmerzbehandlung basiert im Wesentlichen auf Medikamenten. Bei Morbus Parkinson und Ruckenmarksverletzungen konnte die stochastische Resonanztherapie zentral- und periphernervale Interaktionsmechanismen positiv beeinflussen, was mit einer Verbesserung der posturalen Kontrolle einherging. Ziel: Untersuchung des Einflusses der stochastischen Resonanztherapie bei Patienten mit peripherer Neuropathie auf Vibrationsempfinden, Schmerz, statische und dynamische posturale Kontrolle. Methode: Fur die randomisierte klinische Studie wurden 32 Patienten mit Polyneuropathie randomisiert in Experimental- und Kontrollgruppe eingeteilt. Die Experimentalgruppe erhielt uber einen Zeitraum von 8 Wochen 2-mal wochentlich stochastische Resonanztherapie, die Kontrollgruppe eine Wassertherapie. Ergebnisse: Die Schmerzintensitat auf der Visuellen Analogskala verringerte sich in beiden Gruppen: in der Experimentalgruppe um 18,8 mm, in der Kontrollgruppe um 5,06 mm. Die Verbesserungen im Intergruppenvergleich waren nicht signifikant. Das Vibrationsempfinden verbesserte sich im Pra-post-Vergleich ebenfalls. Am Messpunkt des linken Groszehengrundgelenks zeigte sich eine statistisch nicht signifikante Verbesserung des Vibrationsempfindens von 2,13 auf 2,47 (Experimentalgruppe) und von 1,82 auf 2,94 (Kontrollgruppe). Die Verbesserungen waren an allen anderen Messpunkten gleichermasen nicht signifikant. Die statische und dynamische posturale Kontrolle konnte verbessert werden, die Ergebnisse waren jedoch nicht signifikant (p > 0,05). Schlussfolgerungen: Die stochastische Resonanztherapie zeigt bei Patienten mit Polyneuropathie klinisch positive Effekte. Allerdings ist sie bei Patienten mit peripherer Neuropathie einer Wassertherapie nicht uberlegen. Die weitere Untersuchung von Ganzkorpervibrationen beim Krankheitsbild der peripheren Neuropathie ware notwendig, um mehr Wissen uber diesen Sachverhalt zu generieren.

Die Behandlungsergebnisse bei fortgeschrittenen Kopf-Halstumoren konnten durch modifizierte Fraktionierungsschemata oder Kombination mit einer Chemotherapie signifikant verbessert werden. Allerdings zeigt sich auch eine gestiegene Spattoxizitat. Schluckstorungen spielen dabei eine wichtige Rolle, da sie die Lebensqualitat der Patienten besonders beeintrachtigen und lebensbedrohliche Folgen haben konnen. Erste Untersuchungen konnten einen Zusammenhang zwischen der Dosisbelastung an bestimmten schluckrelevanten Strukturen und dem Risiko einer Dysphagie aufweisen, wobei sich die Mm. constrictores pharyngis sowie der supraglottische und glottische Larynx als wichtige Strukturen abzeichnen. Eine gezielte Schonung bei der IMRT-Optimierung sollte, soweit die Tumorlokalisation es zulasst, angestrebt werden. Allerdings stehen prospektive Untersuchungen unter Verwendung standardisierter Protokolle der Dysphagiediagnostik zur Validierung anzustrebender Dosisgrenzwerte noch aus. Auserdem kann die Schonung mittels IMRT nur als ein Ansatzpunkt angesehen werden, und ein Erfolg ist nur durch weitere interdisziplinare Forschung mit HNO/MKG-Chirurgie, Phoniatrie und Logopadie zu erreichen.

The development of imaging technologies has contributed to the understanding of the genesis and pathophysiological mechanisms of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Fundus autofluorescence (FAF) imaging allows accurate discrimination of the boundaries of atrophic patches. Furthermore, predictive markers for disease progression can be identified. Non-invasive FAF imaging now represents the gold standard for evaluating progressive enlargement of atrophic areas. By means of high resolution optical coherence tomography (OCT) microstructural retinal changes in GA can be identified. Anatomical endpoints are now being used in interventional GA trials and represent meaningful outcome parameters as surrogate markers in an overall slowly progressive disease which may not affect the fovea until later stages of the disease.

Integration of PET into radiation treatment planning causes several technical problems, which have not yet been solved satisfactory up to now, but which are currently investigated intensively. First solutions of some aspects such as geometrically correct ROI delineation and the translation of this information into DICOM-RT Structure Sets for import into the radiation treatment planning systems have already been developed, but are not yet generally available. It is to be expected, however, that the dynamic technical development will continue in the next years and lead to solution of the currently persisting problems.

BACKGROUND: Hepatocellular carcinomas are among the most frequent solid tumour entities worldwide. Because of the advanced tumour stage frequently observed at diagnosis a tumour resection as a curative treatment option is often impossible. Therefore the consideration of alternative treatment methods (possibly enhancing the chance of a subsequent tumour resection) and the improvement of existing palliative treatment options are gaining considerable importance. CASE REPORT: A 77-years-old female patient was diagnosed to have a rapidly progredient expansion in the liver in August 2003. Due to its large extension a local tumour resection was impossible and therefore a hyperfractionated accelerated radiotherapy up to a total dose of 55.0 Gy (single dose 1.2 Gy / 1.3 Gy 2 daily fractions, 12 fractions per week, overall treatment time: 27 days) was applied to both well-definable expansions (segments IV and V) from September to October 2003. RESULTS: Despite the large target volume (about 50 % of the total liver volume) at an extended HCC and considering the fact that initially symptomatic treatment was aimed at, a curative tumour resectability with subsequent R 0 partial liver resection at an interval of 9 months could be achieved by means of radiotherapy treatment.

International audience; AbstractRaptors may contract highly pathogenic avian influenza virus H5N1 by hunting or scavenging infected prey. However, natural H5N1 infection in raptors is rarely reported. Therefore, we tested raptors found dead during an H5N1 outbreak in wild waterbirds in Mecklenburg-Western Pomerania, Germany, in 2006 for H5N1-associated disease. We tested 624 raptors of nine species—common buzzard (385), Eurasian sparrowhawk (111), common kestrel (38), undetermined species of buzzard (36), white-tailed sea eagle (19), undetermined species of raptor (12), northern goshawk (10), peregrine falcon (6), red kite (3), rough-legged buzzard (3), and western marsh-harrier (1)—for H5N1 infection in tracheal or combined tracheal/cloacal swabs of all birds, and on major tissues of all white-tailed sea eagles. H5N1 infection was detected in two species: common buzzard (12 positive, 3.1%) and peregrine falcon (2 positive, 33.3%). In all necropsied birds (both peregrine falcons and the six freshest common buzzards), H5N1 was found most consistently and at the highest concentration in the brain, and the main H5N1-associated lesion was marked non-suppurative encephalitis. Other H5N1-associated lesions occurred in air sac, lung, oviduct, heart, pancreas, coelomic ganglion, and adrenal gland. Our results show that the main cause of death in H5N1-positive raptors was encephalitis. Our results imply that H5N1 outbreaks in wild waterbirds are more likely to lead to exposure to and mortality from H5N1 in raptors that hunt or scavenge medium-sized birds, such as common buzzards and peregrine falcons, than in raptors that hunt small birds and do not scavenge, such as Eurasian sparrowhawks and common kestrels.

Background Folliculitis decalvans leads to scarring alopecia through inflammatory destruction of the hair follicle. Currently, antibiotics are most commonly used to treat this disease. However, treatment regimens with antibiotics feature a high relapse rate and encourage the development of resistant bacteria. Objective To evaluate the outcome of different treatment options for folliculitis decalvans. Methods Retrospective study to compare the efficacy of different treatment regimens in 28 patients with folliculitis decalvans. Results The success of treatment with clindamycin and rifampicin, clarithromycin, dapsone and isotretinoin was analysed. The evaluation of the combination of clindamycin and rifampicin showed the lowest success rate in achieving long-term remission, since 80% of the patients relapsed shortly after end of treatment. Clarithromycin and dapsone were more successful with long-term and stable remission rates of 33% and 43% respectively. Treatment with isotretinoin was the most successful oral treatment in our analysis with 90% of the patients experiencing stable remission during and up to two years after cessation of the treatment. Conclusion The common use of antibiotics as first-line therapy in folliculitis decalvans needs to be re-evaluated critically and oral isotretinoin should be considered as valid treatment alternative.

Experimental research on the effects of treatments with homeopathic preparations on plants was last reviewed in 1990. The objective was to compile a systematic literature review on plant bioassays in homeopathic basic research using predefined criteria. A literature search was carried out on publications that reported experiments with homeopathic preparations on whole plants, seeds, plant parts and cells from 1920 to 2010, in healthy, abiotically or biotically stressed conditions. Outcomes had to be measured by established state-of-the-art procedures and statistically evaluated. Using a Manuscript Information Score (MIS), publications were identified that provided sufficient information for proper interpretation (MIS > 5). Further evaluation focused on the use of adequate controls to investigate specific effects of homeopathic preparations and on the use of systematic negative control experiments to ensure proper system performance. A total of 157 publications with plants were identified. The 157 publications described a total of 167 experimental studies. Eighty-four studies included statistics and 48 had a MIS > 5 allowing proper interpretation. Twenty-nine studies were identified with adequate controls to identify specific effects of homeopathic preparations, reporting significant effects of decimal and centesimal homeopathic potencies, including dilution levels beyond Avogadro’s number. Studies that tested series of consecutive potency levels reported a non-linear and discontinuous relation between effect and potency level. There were many individual studies with diverse methods and very few replication trials. Ten studies reported use of systematic negative control experiments, yielding evidence for the stability of the experimental set-up. Plant models appear to be a useful approach to investigate basic research questions on homeopathic preparations, but more independent replication trials are needed. Systematic negative control experiments should be implemented on a routine basis to exclude false-positive results.

MRI of lung airspaces using gases with MR-active nuclei ((3) He, (129) Xe, and (19) F) is an important area of research in pulmonary imaging. The volume-controlled administration of gas mixtures is important for obtaining quantitative information from MR images. State-of-the-art gas administration using plastic bags (PBs) does not allow for a precise determination of both the volume and timing of a (3) He bolus.A novel application unit (AU) was built according to the requirements of the German medical devices law. Integrated spirometers enable the monitoring of the inhaled gas flow. The device is particularly suited for hyperpolarized (HP) gases (e.g., storage and administration with minimal HP losses). The setup was tested in a clinical trial (n = 10 healthy volunteers) according to the German medicinal products law using static and dynamic ventilation HP-(3) He MRI.The required specifications for the AU were successfully realized. Compared to PB-administration, better reproducibility of gas intrapulmonary distribution was observed when using the AU for both static and dynamic ventilation imaging.The new AU meets the special requirements for HP gases, which are storage and administration with minimal losses. Our data suggest that gas AU-administration is superior to manual modes for determining the key parameters of dynamic ventilation measurements.

Die manuelle Medizin (Chirotherpie) stellt ein Therapieverfahren dar, welches insbesondere bei der Behandlung von Wirbelsaulenbeschwerden einen festen Platz in der Orthopadie und Physiotherapie hat. Die vom Untersucher diagnostizierten segmentalen Bewegungseinschrankungen der Wirbelsaule (Blockierung/Hypomobilitat) werden durch gezielte Griffe gelost. Das Substrat einer solchen Blockierung ist dem Rontgen bzw. CT und NMR nicht zuganglich. Ziel der vorliegnden Untersuchung war es, bewegungsgestorte Segmente (Facettengelenke) der Wirbelsaule mit Hilfe der Knochenszintigraphie (SPECT: Single Photon Emission Computed Tomographie) darzustellen. 13 ambulante Patienten der Poliklinik der Orthopadischen Universitatsklinik Marburg ohne relevante Vorerkrankungen wurden mit Wirbelsaulenbeschwerden vorstellig. Diese Patienten demonstrierten in der manualmedizinischen Untersuchung eine Blockierung eines Wirbelsegments. Sie wurden zusatzlich mit einer Knochenszintigraphie (SPECT) in der Abteilung fur Nuklearmedizin untersucht. In 75% der untersuchten Falle wurde durch die klinische und knochenszintigraphische Untersuchung ubereinstimmend das gleiche gestorte Wirbelsaulensegment (Facettengelenk) dignostiziert. In 83% der Fallle wurd ubereinstimmend die gleiche Seite des blockierten Wirbelsaulensegments (Facettengelenk) von beiden Methoden (Manuelle Medizin/Kochenszintigraphie) erkannt. Die Untersuchung zeigte, dass manualmedizinisch diagnostizierte Blockierungen mit charakteristischen Anderungen im Knochenszintigramm einhergingen, ohne dass ein Tumor oder ein entzundlicher bzw. degenerativer Prozess fur die gesteigerte Stoffwechselaktivitat der Osteoblasten verantwortlich gemacht werden konnte. Moglicherweise fuhrt eine Gelenkblockierung durch Verschiebung der momentanen Drehachse zu einer erhohten Belastung, die eine Aktivitatssteigerung der Osteoblasten bewirkt.

Electric field and temperature-dependent electron injection studies have been performed in an aluminum (Al)/tris(8-hydroxy-quinolinolato)aluminum (Alq 3 )/magnesium (Mg):silver (Ag) single-layer organic light-emitting diode (OLED). Semiconductor textbook theories, such as Fowler–Nordheim (FN) model for tunneling injection or Richardson–Schottky (RS) model for thermionic emission cannot account for the experimentally observed dependence of the injection current on electric field and temperature. Excellent agreement with experiment is provided by a Monte Carlo simulation of carrier injection from a metal into an organic dielectric with random hopping sites.

Novel VOx catalysts have been developed for the partial oxidation of methane to formaldehyde by air. High surface area mesoporous siliceous MCM-41 and MCM-48 materials have been used as supports to disperse vanadium oxide to prevalent monomeric, i.e., isolated vanadium oxide species, being necessary to minimize the consecutive oxidation of the desired product to carbon oxides. On these supports, a higher concentration of isolated active sites can be obtained than on conventional silica supports. Vanadium oxide was deposited by impregnation with aqueous solutions of NH4VO3 and VO(C2O4), respectively, followed by calcination of the precursor at 873 K for 16 h. The dispersity and the nature of the vanadium oxide species, i.e., their valence state, coordination, and location on and inside the pore walls, were studied by temperature-programmed reduction, potentiometric titration, solid state 51V NMR, ESR, and UV-Vis spectroscopy. FTIR spectroscopy was used to characterize the acidic porperties. Different vanadium oxide species were observed: (i) VIVOx and VVOx species anchored to the siliceous MCM walls and (ii) VIVOx and VVOx species incorporated into the pore walls. VVOx species anchored to the surface showed properties similar to those on conventional VOx/SiO2 catalysts. However, it was found that the VOx species carry acidic V–OH groups, at least partially. The catalytic properties of the catalysts were tested in a plug flow reactor. Reaction orders with respect to methane and oxygen, respectively, as well as the apparent activation energy were comparable with those reported for vanadium oxide supported on precipitated silica, pointing to similar active sites. However, significant higher space-time yields of formaldehyde could be achieved amounting to about 2.2 kg·kgcat−1·h−1. Increased activity during cofeeding of steam could be observed due to the generation of VVO(OH)x(OSi≡)3−x surface species or the corresponding “reduced sites” VIVO(OH)x(OSi≡)2−x supposed as genuine active sites.

INTRODUCTION One of the most important tasks of manual therapists is the treatment of hypomobile intervertebral joints. Such conditions of the spine are treated with various manipulations or mobilisation. The pathophysiological basis of hypomobility is still under discussion. Objective criteria for the diagnosis of impaired spinal mobility are not available. Nor is any substrate detectable by X-ray, computed tomography or NMR. AIM To find evidence of a biomechanical alteration of hypomobile intervertebral joints with the aid of SPECT (Single Photon Emission Computed Tomography). STUDY DESIGN 13 outpatients with back pain but otherwise healthy attending the Orthopaedic University Hospital in Marburg were examined by manual medical means, and were found to have hypomobility of an intervertebral joint. In addition, the spines of these patients were examined with SPECT (bone scanning). RESULTS Comparison of the results of physical examination and bone scanning revealed that in 75% of all the cases the location (spinal segment) of the hypomobility identified by each of the two methods was identical. In 83%, they were in agreement on which of the sides (facet joint) was affected.

Substantial clinical evidence shows the efficacy of low dose radiotherapy (RT) in the treatment of painful osteoarthritis. Experimental investigations into these empirically clinical observations remain scarce. This study investigated in vivo the effects of daily 5 x 1.0 Gy versus 5 x 0.5 Gy on adjuvant induced arthritis in rats in order to explore whether there is a dose dependence of anti-inflammatory efficacy.Adjuvant arthritis in female Lewis rats was induced by intradermal injection of heat inactivated Mycobacterium tuberculosis on day 0. Both hind paws were X-irradiated daily from days 15 to 19 after induction according to four protocols (15 animals/group): group 1, 5 x 1.0 Gy (non-arthritic animals); group 2, sham-irradiated control; group 3, 5 x 1.0 Gy; group 4, 5 x 0.5 Gy. The clinical parameters arthritis score (AS), hind paw volume (HPV), body weight, and erythrocyte sedimentation rate (ESR) were determined. On days 21 and 30 histological sections of at least 12 ankle joints per group were analysed semi-quantitatively.Local irradiation of non-arthritic rats (group 1) with 5 x 1 Gy did not induce any arthritic signs. Sham-irradiated arthritic rats (group 2) showed a full-blown arthritic syndrome. Treatment of arthritic rats with 5 x 1 Gy (group 3) or 5 x 0.5 Gy (group 4) led to a reduction of mean AS from day 21 to 29 compared with group 2 (days 27-29--group 3: p=0.037; group 4: p=0.034), with no differences in efficacy between groups 3 and 4. Concurrently, following radiation treatment there was no further increase in HPV. At the end of the observation period, this effect demonstrated a dose-dependent level of significance (days 27-29--group 3: p=0.0036; group 4: p=0.039). A significant decrease in the ESR was noted in both irradiated arthritic groups on day 21 (group 3: p=0.015; group 4: p=0.006). The histopathological analysis revealed a highly significant reduction of cartilage and bone destruction on day 30 in both irradiated groups.This study confirms by objective criteria the anti-inflammatory efficacy of low dose RT and gives some indication for a dose dependence of its efficacy.

Based upon Monte-Carlo simulations, analytic theory, and experiment a hopping concept for charge injection into random organic p-functional dielectrics is been developed and tested. The treatment is exible enough to include interfacial properties and to incorporate space charge limited current ow. A hopping concept has also been employed to analyse experimental data on the hole mobility in conjugated polymers. The time response of LEDs, though more complicated, can be rationalized in terms of self-consistent analytic theory. It has been applied to tunneling controlled time dependent electroluminescence in a bilayer LED.

On the basis of our own calorimetric data and of known equilibria data the phase equilibria in the system Mg–H have been completely calculated by means of an optimization. Both for α-MgHx and MgH2 optimized free enthalpy functions are obtained.

We have performed electric-field and temperature-dependent electron injection studies in an aluminum/tris(8-hydroxy-quinolinolato)aluminum/magnesium:silver single-layer organic light-emitting diode. Analysis of the observed injection currents in terms of the classic Fowler-Nordheim (FN) tunneling or Richardson-Schottky (RS) thermionic emission proved to be inadequate. Whereas, the FN-type behavior at high-electric fields must be considered accidental, the injection currents qualitatively resemble those of the RS concept. However, quantitative differences are observed concerning the RS coefficient, the prefactor current, and the temperature dependence. On the other hand, the experimental data are in excellent agreement with a recently presented Monte Carlo simulation [U. Wolf et al., Phys. Rev. B 59, 7507 (1999)] of carrier injection from a metal to an organic dielectric with random hopping sites.

The investigation of the surface composition of vanadyl pyrophosphate catalysts and the influence of Cs ions and of water vapor on the surface P/V ratio were described and discussed. The characterization was carried out by XPS (X-ray Photoelectron Spectroscopy) and ISS (Ion Scattering Spectroscopy). It was concluded that the P/V ratio on the surface of equilibrated and non equilibrated (VO) 2 P 2 O 7 catalysts prepared in aqueous solution was between 1.3 and 1.4 (XPS) based on calibrations with different VPO glasses as standard materials having uniform composition of surface and bulk. In the outermost layer of the catalyst the P/V ratio was much higher and laid between 2 and 3 as verified by ISS. Different influences, i.e. addition of alkali metall ions (Cs + ) or a treatment with water vapor of the catalyst, caused a further increase in the concentration of phosphorus on the surface.