Departments In Germany Research Articles

MOONLIGHT: a controlled registry of an iridium oxide-coated stent with angiographic follow-up

Carlo Di Mario*, Eberhard Grube, Yilmaz Nisanci, Nicholaus Reifart, Antonio Colombo, Jorg Rodermann, Ralf Muller, Sabahattin Umman, Francesco Liistro, Matteo Montorfano, Eckard Alt Department of Interventional Cardiology San Raffaele Hospital and Columbus Clinic, Milan, Italy Department of Interventional Cardiology San Raffaele Hospital and Columbus Clinic, Siegburg, Germany Department of Interventional Cardiology San Raffaele Hospital and Columbus Clinic, Alman Hospital, Istanbul, Turkey Department of Interventional Cardiology San Raffaele Hospital and Columbus Clinic, Bad Soden, Germany Department of Interventional Cardiology San Raffaele Hospital and Columbus Clinic, Tulane University, New Orleans, LO, USA

Sensibilisierung auf Teebaumöl in Deutschland und Österreich – Eine multizentrische Studie der Deutschen Kontaktallergiegruppe

Zusammenfassung Hintergrund und Fragestellung: Teebaumöl, ein Destillationsprodukt der Blätter des australischen Teebaumes Melaleuca alternifolia, erfreut sich zunehmender Beliebtheit als Alternativheilmittel für die Behandlung diverser Hauterkrankungen. Das Öl ist ein Gemisch aus zahlreichen allergologisch relevanten Substanzen wie Monoterpenen und Sesquiterpenen. In dieser multizentrischen Studie sollte evaluiert werden, ob die Zunahme des Verbrauches von Teebaumöl zu einer Sensibilisierungshäufigkeit in Deutschland und Österreich geführt hat, die die Aufnahme in die Standardreihe rechtfertigen würden. Patienten und Methode: Für die Epikutantestung wurde ein standardisiertes Teebaumöl, 5 % in Diethylphthalat (DEP), verwendet. Getestet wurden konsekutive Ekzem‐Patienten von 11 Hautkliniken in Deutschland und Österreich. Die Ablesung erfolgte nach zwei und drei Tagen gemäß den Empfehlungen der Deutschen Kontaktallergiegruppe (DKG). Ergebnisse: Von insgesamt 3 375 getesteten Patienten reagierten 36 (1,1 %) positiv auf Teebaumöl. Die Sensibilisierungshäufigkeit zeigte große geographische Unterschiede von 2,3 % (Dortmund), 1,7 % (Buxtehude), 1,1 % (Essen), 0,7 % (Graz) bis 0 % (Berlin, Wien). 14/36 Patienten (38,9 %) zeigten auch eine positive Reaktion auf Terpentin. Schlußfolgerung: Für einzelne Testzentren ist Teebaumöl ein wichtiges Allergengemisch. Bei anamnestischen Hinweisen über die Anwendung teebaumölhaltiger Produkte sollte es getestet werden. Angesichts der großen regionalen Unterschiede in der Sensibilisierungshäufigkeit ist die Aufnahme in die Standardreihe noch nicht zu empfehlen.

Value of endotracheal tube safety in laryngeal laser surgery.

Due to the increased popularity of laryngeal laser therapy, surgeons and anesthesiologists are inevitably confronted with questions concerning the choice of the most efficient endotracheal tube (ETT) for laryngeal laser surgery, especially with regard to possible endolaryngeal tube fires, or combustions. The purpose of this study was to determine the current practice in endolaryngeal laser surgery in Germany. A questionnaire was sent to 152 ENT Departments in Germany, care was taken that the responders could send back the questionnaire anonymously. Among other questions the participants were asked for the number of lasersurgical treatments of the larynx performed in the past, the usual type of ETTs in use, whether other safety precautions were taken during CO2 laser surgery of the larynx and for intraoperative complications like tube ignition, fires or combustions. Eighty six of the 152 addressed ENT departments replied. In laryngeal laser surgery, 59/86 departments regularly use special laser tubes in daily routine (74.5%). In about 20,000 lasersurgical procedures, 15 incidents of ETT fire have been reported. In six of the reported 15 cases a tube fire occurred despite the fact that special laser tubes had been utilized. The present study could demonstrate that the use of special laser tubes does not necessarily protect against ETT fire. Thus, even when using special laser tubes other safety measures should be taken. In view of the maximum safety for the patient it has to be stated, that the safety during surgery correlates definitely with the experience of the surgeon. The weakest point of ETTs is usually situated in the cuff region.

Randomized comparison of enoxaparin with unfractionated heparin for the prevention of venous thromboembolism in medical patients with heart failure or severe respiratory disease

Background We compared the efficacy and safety of the low-molecular weight heparin enoxaparin with unfractionated heparin (UFH) for the prevention of venous thromboembolic disease in patients with heart failure or severe respiratory disease. Methods This was a multicenter, controlled, randomized, open study in which patients received either enoxaparin (40 mg once daily) or UFH (5000 IU 3 times daily) for 10 ± 2 days in 64 medical departments in Germany. Patients were stratified and enrolled according to their underlying disease: severe respiratory disease or heart failure. The primary efficacy parameter was a thromboembolic event up to 1 day after the treatment period. Results Of the 665 patients enrolled, 451 patients were able to be evaluated in the primary efficacy analysis. The incidence of thromboembolic events was 8.4% with enoxaparin and 10.4% with UFH. Enoxaparin was at least as effective as UFH, with a 1-sided equivalence region of −4% (90% CI −2.5-6.5, P = .015). Enoxaparin was associated with fewer deaths, less bleeding, and significantly fewer adverse events (45.8% vs 53.8%, P = .044). Conclusions Enoxaparin is at least as effective as UFH in the prevention of thromboembolic events in patients with heart failure or severe respiratory disease. Its beneficial safety profile and once-daily administration is advantageous for inpatient and outpatient use. (Am Heart J 2003;145:614-21.)

Diagnosis and management of testicular intraepithelial neoplasia (carcinoma in situ)--surgical aspects.

Germ cell tumours (CT) are no true carcinomas; therefore the term testicular intraepithelial neoplasia (IN) is probably more appropriate than "CIS". The diagnostic accuracy of a single-site biopsy is an open question. We experienced 9 false-negative biopsies among 1859 cases. Thus, the proportion of a failed diagnosis is 0.5%. The main reason for diagnostic failure is the non-random distribution of TIN within the testicle. Currently we are investigating whether a two-site biopsy is more accurate than a single biopsy. In the ongoing trial, the over-all prevalence of TIN is around 5.3%, so far. In one quarter of the positive cases the lesion was found in only one of the two specimens. Thus, a double biopsy appears to be more favourable than the traditional single biopsy. Surgical complications amount to 2.5% in that double biopsy study. Only one surgical re-intervention was required among 983 patients. Serial imaging studies with scrotal sonography and magnetic resonance imaging (MRI) disclosed a transient intratesticular haematoma/oedema postoperatively. So, testicular biopsy, even when performed at two sites is in fact a low-complication procedure. Low dose radiotherapy to the testis is the treatment of choice for TIN. However, more than one quarter of patients require testosterone supplementation secondary to androgen-deficiency. Two dose-reduction studies (Denmark and Germany) had to be terminated prematurely because unexpected relapse of TIN was encountered at 14 Gy and 16 Gy. Possibly, hyperfragmentation schedules can overcome the antagonism of androgenic compromise and oncological safety. In a nation-wide survey, it was shown that contralateral biopsies were routinely performed in 66% of the urological departments in Germany. Another 19% offered the biopsy to particular "risk-cases"; only 15% never did a biopsy. Among those refusing biopsies, there was a higher proportion of small hospitals and a significantly lower annual case-number of GCT, when compared to those doing the biopsy. Thus, the contralateral biopsy is a well-established procedure among German urologists; those with a high caseload of GCT particularly appreciate it.

Ergebnisse einer Umfrage zur fußchirurgischen Operationsaktivität an orthopädischen Kliniken und Hauptabteilungen in Deutschland

Summary Nationwide collecting evaluations for the foot surgical operation activity on orthopaedic clinics and departments in Germany are not available up to now. For extraction of a survey, we carried out this inquiry at German clinics and orthopaedic departments under two aspects: how great is the annual feet surgical operation appearing on orthopaedic clinics at all and which functional techniques come in case of specific – typical – clinical pictures to application? The data are based on own information of the clinics and offer a good survey of foot surgical activities at orthopaedic handles in Germany. At the most houses one carries out in 75% of cases forefoot surgery and in 25% of the cases, rearfoot surgery. The ambulant foot surgery is no emphasis at German clinics, the pedobarography is no means of routine diagnostic. The information confirms the variety of the functional therapy in treatment of classical forefoot surgical questions. Very obviously the well criticized resectionarthroplasty is still noticed as a good therapeutic option in all clinical pictures despite of the heaviness of forefoot malposition.

Increased sensitivity of the macroinvertebrate Paramorea walkeri to heavy-metal contamination in the presence of solar UV radiation in Antarctic shoreline waters

MEPS Marine Ecology Progress Series Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsTheme Sections MEPS 255:183-191 (2003) - doi:10.3354/meps255183 Increased sensitivity of the macroinvertebrate Paramorea walkeri to heavy-metal contamination in the presence of solar UV radiation in Antarctic shoreline waters Sabine Duquesne1,*, Matthias Liess1,2 1Department of Chemical Ecotoxicology, UFZ Centre for Environmental Research, Permoserstrasse 15, 04318 Leipzig, Germany 2Department of Limnology and Environmental Protection, PO Box 27, 00014 University of Helsinki, Finland *Email: sabine.duquesne@onlinehome.de ABSTRACT: A previous laboratory investigation showed that the Antarctic gammarid amphipod Paramorea walkeri is more sensitive to heavy metals when exposed to UV-B radiation. The question addressed in this study is whether this effect is also observed when the species is exposed to combined solar UV radiation and heavy-metal contamination under field conditions. In situ bioassays using P. walkeri showed that exposure to field contamination resulted in a significant decrease of survival. The effects observed were stronger than expected according to the characteristics of the contamination. The hypothesis that solar UV radiation can increase the sensitivity of organisms to metal contaminants was thus tested in an outdoor test system. This revealed that the mortality recorded under exposure to both parameters was increased compared to mortalities resulting from exposure to each single parameter. This increased sensitivity of amphipods to heavy metals in the presence of UV-radiation is discussed as an explanation for the absence of this species in contaminated shallow waters. The effects observed at the individual level would thus be reflected at a population level. This work highlights the necessity to consider environmental parameters such as UV radiation in Antarctica to improve the predictive power in ecological risk assessment. KEY WORDS: UV-B · Heavy-metal contamination · Environmental parameters · Higher-tier risk assessment · Amphipod Full text in pdf format PreviousNextExport citation RSS - Facebook - Tweet - linkedIn Cited by Published in MEPS Vol. 255. Online publication date: June 24, 2003 Print ISSN: 0171-8630; Online ISSN: 1616-1599 Copyright © 2003 Inter-Research.

Letters to the Editor

Professor, Department of Obstetrics and Gynecology; J. W. Goethe University; Frankfurt, Germany Department of Obstetrics and Gynecology; J. W. Goethe University; Frankfurt, Germany

Letters to the Editor

Professor, Department of Obstetrics and Gynecology; J. W. Goethe University; Frankfurt am Main, Germany Department of Obstetrics and Gynecology; J. W. Goethe University; Frankfurt am Main, Germany

The strict separation of clinical and academic budgets: an analysis at a German medical university department of anaesthesia

In the past, cross-funding between medical and academic budgets has been commonly practised at university medical departments in Germany. Recent developments have however, generated pressures to enforce the separation of funding for both areas, as intended by law, and to distribute them on the basis of performance. A pilot project at Münster University Hospital, initiated by the German Federal Ministry for Research and Education in 1998, is described here. The main aim of the project was to find ways of distinguishing between research and teaching areas, on the one hand, and health care on the other, in terms of documenting performance and itemizing costs.

Continuous and intermittent sibutramine were equally effective at 44 weeks for reducing weight in obesity

(2001) JAMA 286, 1331. Wirth A, Krause J. . Long-term weight loss with sibutramine: a randomized controlled trial. . Sep 19; . : . –9 . [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] QUESTION:...

SKP1-SnRK protein kinase interactions mediate proteasomal binding of a plant SCF ubiquitin ligase.

Arabidopsis Snf1-related protein kinases (SnRKs) are implicated in pleiotropic regulation of metabolic, hormonal and stress responses through their interaction with the kinase inhibitor PRL1 WD-protein. Here we show that SKP1/ASK1, a conserved SCF (Skp1-cullin-F-box) ubiquitin ligase subunit, which suppresses the skp1-4 mitotic defect in yeast, interacts with the PRL1-binding C-terminal domains of SnRKs. The same SnRK domains recruit an SKP1/ASK1-binding proteasomal protein, alpha4/PAD1, which enhances the formation of a trimeric SnRK complex with SKP1/ASK1 in vitro. By contrast, PRL1 reduces the interaction of SKP1/ASK1 with SnRKs. SKP1/ASK1 is co-immunoprecipitated with a cullin SCF subunit (AtCUL1) and an SnRK kinase, but not with PRL1 from Arabidopsis cell extracts. SKP1/ASK1, cullin and proteasomal alpha-subunits show nuclear co-localization in differentiated Arabidopsis cells, and are observed in association with mitotic spindles and phragmoplasts during cell division. Detection of SnRK in purified 26S proteasomes and co-purification of epitope- tagged SKP1/ASK1 with SnRK, cullin and proteasomal alpha-subunits indicate that the observed protein interactions between SnRK, SKP1/ASK1 and alpha4/PAD1 are involved in proteasomal binding of an SCF ubiquitin ligase in Arabidopsis.

Epiretinal membranes after extracapsular cataract surgery

Purpose To determine whether uneventful extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC IOL) implantation induces epiretinal membranes (ERMs). Setting Private practice, with statistical evaluation at a university department in Germany. Methods This prospective study comprised 296 consecutive patients (332 eyes) who had uneventful ECCE with PC IOL implantation for senile cataract. Eyes were examined within 2 weeks preoperatively and 2 weeks and 6, 9, and 12 months postoperatively. The macula was examined with a 78.0 diopter Volk lens. The main outcome measure was the presence of ERM. The membranes were classified as present when cellophane macular reflex (CMR) or macular pucker (MP) was observed. Results The median age of the patients was 78 years (range 50 to 97 years). At baseline, ERM was present in 49 of 332 eyes (14.8%), 40 (12.1%) with CMR and 9 (2.7%) with MP. Six months postoperatively, ERM was present in 84 of 332 eyes (25.3%), 72 (21.7%) with CMR and 12 (3.6%) with MP. The difference between the baseline and 6 month incidence was significant ( P < .001). All new cases of ERM were of the CMR type. One year after surgery, ERM was present in 54 of 198 eyes (27.3%), 47 (23.7%) with CMR and 7 (3.5%) with MP. The ERMs rarely influenced visual acuity; however, 6 of 12 eyes (50.0%) with MP and 13 of 72 (18.1%) with CMR had metamorphopsia. Conclusions The prevalence of ERM increased by 71.4% during the first 6 months after uneventful ECCE with PC IOL implantation. Thereafter, the prevalence remained about the same. Newly formed ERMs were probably induced by the uneventful surgery. Although new-onset membranes usually do not preclude good visual acuity, they can cause metamorphopsia postoperatively.

Sign reversal of the orbital moment via ligand states

I. Galanakis, P. M. Oppeneer, P. Ravindran, L. Nordstrom, P. James, M. Alouani, H. Dreysse, and O. Eriksson Institut de Physique et Chimie des Materiaux de Strasbourg, F-67037, Strasbourg, France Institute of Solid State and Materials Research, P.O. Box 270016, D-01171 Dresden, Germany Department of Chemistry, University of Oslo, P.O. Box 1033, N-0315 Oslo, Norway Department of Physics, Uppsala University, Box 530, S-75112 Uppsala, Sweden ABB Corporate Research, Vasteras, Sweden ~Received 1 December 2000; published 2 April 2001!

Regional localization of 10 mariner transposon-like ESTs by means of FISH--evidence for a correlation with fragile sites.

Institute of Human Genetics and Anthropology, D-07740 Jena, Germany Department of Biology, UCSD, Bonner Hall Room, 4218 9500 Gilman Drive, La Lolla, California 92303-0349, USA Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030 USA Department of Neurology, Kumamto University School of Medicine, Honjo 1-1-1, Kumamto 860-0811, Japan Institute of Human Genetics, D-91054 Erlangen, Germany

Demonstration of a hybrid collisional soft-x-ray laser

K. A. Janulewicz, J. J. Rocca, F. Bortolotto, M. P. Kalachnikov, V. N. Shlyaptsev, W. Sandner, and P. V. Nickles Max Born Institute, Max-Born-Strasse 2A, D-12489 Berlin, Germany Department of Electrical and Computer Engineering, Colorado State University, Fort Collins, Colorado 80523 Department of Applied Science, UC Davis-Livermore, California 94550 ~Received 1 September 2000; published 6 February 2001!

Health care providers on the World Wide Web: quality of presentations of surgical departments in Germany

It is becoming increasingly common for health care providers to present information on the World Wide Web (WWW). Patients, as well as health care professionals, do not really know what they can expect today. Many quality criteria are proposed for the assessment of medical Internet sites focusing mainly on structure and content management. The objective of this study was to assess the quality of presentations by health care providers on the WWW and to detect strengths and weaknesses with regard to potential target groups, patients, colleagues, and students. A sample of 171 presentations was randomly selected in March 2000 from a collection of 469 surgical departments in Germany. Medical doctors undergoing a full-time training in medical informatics rated the presentations. A previously evaluated questionnaire was used to assess the presentations with regard to 12 criteria about content and technical features. For each criterion the categories 'very good', 'sufficient', and 'insufficient' could be used. Twenty medical doctors assessed 168 presentations with one to seven valuations per presentation. Three presentations could not be accessed at the time of evaluation. Sixty-eight per cent of the median values of each criterion were rated as insufficient. The only criteria rated sufficient or better in at least 50% were: employees/map, survey of offered medical services, navigation, and layout. University hospitals and heart centres achieved significantly better results than regional hospitals. In conclusion, the quality of provider information on the W WW is unsatisfactory. Most surgical departments do not provide information that could help patients to choose their physicians. The criteria set developed here could be a useful tool for a target-group-oriented self-assessment of provider presentations on the World Wide Web.

Health care providers on the World Wide Web: quality of presentations of surgical departments in Germany

Health care providers on the World Wide Web: quality of presentations of surgical departments in Germany

Internet presence of surgical clinics in Germany. Current data and future prospects

The aim of this study was to obtain an overview of the use of the Internet by surgical departments in Germany as a presentation platform and information resource for their patients. After a randomizing a total of 1,760 surgical departments in Germany, 200 were chosen and asked about their Internet use. Most of the questionnaires (81.5%) were received and analyzed; 32.5% of the German surgical departments are represented on the Internet; 81.4% of the clinics without a homepage are planning to have one in the future. The hospitals represent themselves on average on two HTML documents. Approximately a third of the German surgical departments currently give information over the Internet with a wide and heterogeneous spectrum. In the near future approx. 80% of the German surgical departments will have online presence. Therefore, the increasing demand for medical information by the patients will be fulfilled. The professionalism and effectiveness of the home-pages can be increased through registration with many search engines and the use of e-mail.

Building firm trust online

article Free AccessBuilding firm trust online Authors: Detlef Schoder Department of Telematics in the Institute for Informatics and Society (IIG) at the University of Freiburg in Germany Department of Telematics in the Institute for Informatics and Society (IIG) at the University of Freiburg in GermanyView Profile , Pai-Ling Yin dStanford University, CA dStanford University, CAView Profile Authors Info & Claims Communications of the ACMVolume 43Issue 12Dec. 2000 pp 73–79https://doi.org/10.1145/355112.355127Published:01 December 2000Publication History 58citation3,758DownloadsMetricsTotal Citations58Total Downloads3,758Last 12 Months116Last 6 weeks16 Get Citation AlertsNew Citation Alert added!This alert has been successfully added and will be sent to:You will be notified whenever a record that you have chosen has been cited.To manage your alert preferences, click on the button below.Manage my AlertsNew Citation Alert!Please log in to your account Save to BinderSave to BinderCreate a New BinderNameCancelCreateExport CitationPublisher SiteView all FormatsPDF